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235 results of 27 texts with exact phrase : 'MRI'.

1. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, Vol. 1, 2005 , , ,

et al.: Prenatal diagnosis of aneurysms of the vein of Galen with conventional sonography, 3D sonography and MRI: report of 2 cases.
Gerards F., Engels M., Barkhof F. et al.: Prenatal diagnosis of aneurysms of the vein of Galen with conventional sonography, 3D sonography and MRI: report of 2 cases.
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2. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 2, 2006, No. 1 , , ,

cerebral infarction, MRI,
cerebral infarction, MRI,
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3. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 3, 2007, No. 1 , , ,

Now the diffussion-perfussion MRI is widely used to demonstrate the ischemic penumbra and to follow when it proceed to cerebral infarction.
by positron emission tomography and it has been shown that the penumbra could last several hours after a symptom onset. Now the diffussion-perfussion MRI is widely used to demonstrate the ischemic penumbra and to follow when it proceed to cerebral infarction. It has been also shown that the penumbra in stroke patients can be a long-lasting perfussion abnormality. Thus, the visualization of the penumbra allows the treatment decision to be made on the base of the cerebral ischemia pathophysiology, but not on the duration of the neurological deficit. Recently, it has been pointed out that from pathophysiological viewpoint TIA could be defined as an ischemic penumbra of varied duration, which may proceed to cerebral infarction or reduce to oligemia. The neuroprotection in cerebral ischemia is designed to block different stages of the ischemic cascade and to attenuate the pathological apoptosis. The neuroprotective drugs belong to different pharmacological groups and possess various modes of action.
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Трансхемисферната миграция на нервните стволови клетки, трансплантирани в неувредената хемисфера, е проследено in vivo със серийно MRI, след което е провеждано и хистологично изследване.
Приема се, че то се осъществяват главно чрез три механизма: засилване функцията на еNOS; отслабване на възпалителната реакция в исхемичната зона, предизвикана от проинфламаторните цитокини; намаляване на оксидативния стрес в мозъка в резултат на антиоксидантни въздействия [47, 48]. Освен това установено е, че статините увеличават резистентността на култури от корови неврони към глутаматната ексцитотоксичност [53]. Това означава, че вероятно те имат и директни невропротективни ефекти. Напоследък, експериментални проучвания показват, че трансплантирането на стволови клетки при мозъчни инсулти може да разкрие нови перспективи за невропротекция и функционално.възстановяване, вероятно чрез невротрофични въздействия. Намерено е, че при плъхове с едностранен мозъчен инфаркт, трансплантираните в контралатералната хемисфера нервни стволови клетки мигрират до увредената хемисфера и се натрупват около исхемичното огнище. Трансхемисферната миграция на нервните стволови клетки, трансплантирани в неувредената хемисфера, е проследено in vivo със серийно MRI, след което е провеждано и хистологично изследване. Установено е,
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Krol AL, Coutts SB, Simon JE et al, VISION Study Group: Perfusion MRI abnormalities in speech or motor transient ischemic attack patients.
Krol AL, Coutts SB, Simon JE et al, VISION Study Group: Perfusion MRI abnormalities in speech or motor transient ischemic attack patients.
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Liu Y, Karonen JO, Vanninen RL et al: Detecting the subregion proceeding to infarction in hypoperfused cerebral tissue: a study with diffusion and perfusion weighted MRI.
Liu Y, Karonen JO, Vanninen RL et al: Detecting the subregion proceeding to infarction in hypoperfused cerebral tissue: a study with diffusion and perfusion weighted MRI.
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Functional MRI detects posterior shifts in primary sensomotor cortex activation after stroke.
Pineiro R, Pendlebury S, Johnsen-Berg H, Matthews PM. Functional MRI detects posterior shifts in primary sensomotor cortex activation after stroke. Evidence of local adaptive reorganization?
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4. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 3, 2007, No. 2 , , ,

Homocysteine and brain atrophy on MRI of non-demented eldery.
Heijer T, Vermeer SE, Clarke R et al. Homocysteine and brain atrophy on MRI of non-demented eldery.
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5. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 4, 2008, No. 1 , , ,

От 2000 година FDA одобрява MRI до 4 Tesla в клиничната практика и до 8 Tesla при проучванията.
От 2000 година FDA одобрява MRI до 4 Tesla в клиничната практика и до 8 Tesla при проучванията. В първата постерна сесия, касаеща невроизобразяване, бяха представени невероятни изображение при 7 и 9,4 Tesla.
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6. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 4, 2008, No. 2 , , ,

A paralell magnetic resonance imaging (MRI) was applied in 32 patients with AIDCC, 28 patients with RF for CVD and 10 healthy controls.
common carotid arteries (CCA), the presence of atherosclerotic plaques, their severity, echogenicy and stability. A paralell magnetic resonance imaging (MRI) was applied in 32 patients with AIDCC, 28 patients with RF for CVD and 10 healthy controls. The main quantitative parameters for evaluation of external and internal ventricle and the type of white matter changes were determined.
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Healthy persons were without RF for CVD and had normal sonographic and MRI parameters.
Healthy persons were without RF for CVD and had normal sonographic and MRI parameters. In both patient groups AH stage І and ІІ, hypercholesterolemia, smoking and obesity were the most frequent RF for CVD. The combination of AH and dyslipidemia, AH and obesity, AH and heart diseases were predominated. In AIDCC the combination of AH and diabetes was more frequent than in patients with RF for CVD. Compared to controls and patients with RF for CVD in the group with AIDCC a significant enlargement of the ventricles was found. In AIDCC the changes in carotid blood flow and cerebral parehchima progressed with the increase in duration, severity and non-systemic treatment of AH.
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difussion test, MRI,
difussion test, MRI,
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The diffusion test is performed by magnetic resonance imaging (MRI), and the perfusion test – using multidetectional computer tomography (CT).
The aim of the review is to introduce two new imaging methods – diffusion and perfusion tests for detection of morphological and functional changes in vascular and other diseases of the brain and other human organs and systems. The diffusion test is performed by magnetic resonance imaging (MRI), and the perfusion test – using multidetectional computer tomography (CT). Both methods are applied for early diagnosis of various (mainly vascular) disorders of the central nervous system and other human systems by imaging of the vessel’s network (arteries, veins and capillaries) of the pathology process, as well as for control of the treatment and prognosis of the disease.
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7. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 5, 2009, No. 1 , , ,

A paralell magnetic resonance imaging (MRI) was applied.
presence of atherosclerotic plaques, their severity, echogenicy and stability. A paralell magnetic resonance imaging (MRI) was applied.
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Healthy persons were without RF for CVD and had normal sonographic and MRI parameters.
Healthy persons were without RF for CVD and had normal sonographic and MRI parameters. In AIDCC the changes in carotid blood flow and cerebral parenchyma progressed with the increase in duration, severity and non-systemic treatment of AH. There is a negative correlation between duration of AH and cerebral blood flow velocity in AIDCC. Compared to controls and patients with RF for CVD in the group with AIDCC enlargement of the ventricles and trend to confluens of white matter lesions in patients AH stage ІІІ was found.
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Progression of cerebral white matter hyperintensities on MRI is related to diastolic blood pressure.
Veldink JH, Scheltens P, Jonker C. Progression of cerebral white matter hyperintensities on MRI is related to diastolic blood pressure.
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Silent cerebral microbleeds on T2-weighted MRI: correlation with stroke subtype, stroke recurrence and leucoaraiosis,
Kato H, Izumiyama K, Takahashi K. Silent cerebral microbleeds on T2-weighted MRI: correlation with stroke subtype, stroke recurrence and leucoaraiosis,
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Foci of MRI signal (pseudo lesions) anterior to the frontal horns: histologic correlations of a normal finding.
Sze G, De Armond SJ, Brant-Zawadzki M, Davis RL, Norman D, Newton TH. Foci of MRI signal (pseudo lesions) anterior to the frontal horns: histologic correlations of a normal finding.
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8. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 5, 2009, No. 1 , , ,

MRI of clot in cerebral venous thrombosis: high diagnostic value of susceptibility-weighted images.
Idbaih A, Boukobza M, Crassard I, Porcher R, Bousser MG, Chabriat H. MRI of clot in cerebral venous thrombosis: high diagnostic value of susceptibility-weighted images.
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The cerebral parenchyma was assessed by magnetic resonance imaging (MRI) and the vascular system – by digital subtracted angiography and magnetic resonance angiography.
the main head and the basal cerebral arteries is described. The cerebral parenchyma was assessed by magnetic resonance imaging (MRI) and the vascular system – by digital subtracted angiography and magnetic resonance angiography. Routine electroencephalography was applied for evaluation of the brain electric activity.
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Focal leucoencephalopathy and ventriculomegaly were detected by MRI.
Non-specific features and mild neurological and cognitive impairment were found by clinical examination. Modifiable risk factors for cerebrovascular diseases (arterial hypertension, hyperlipidemia and regular smoking) were registered. Hypertonic angiopathy with cholesterol emboli in the retinal vessels were seen by ophtalmoscopy. Chronic thrombosis of the common and internal carotid arteries caused by confluent heterogenic plaques and collateral circulation through the external carotid arteries, the vertebral arteries and the posterior part of the circle of Willis were demonstrated by color-coded duplex scan. A good correlation between the neurosonographic and angiographic findings was established. Focal leucoencephalopathy and ventriculomegaly were detected by MRI. Irregular alpha rhythm from the parietooccipital regions and mild intraocular asymmetry with relatively prolonged P 100 latency on the right side were registered electrophysiologically.
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9. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 6, 2010, No. 1 , , ,

Реваскуларизацията може би има ефект, но само при строго селектирана група от пациенти, при които нарушената церебрална перфузия е доказана с перфузионна CT/ MRI/PET [5].
Поведението в случаите на такива лезии е противоречиво. Хирургичното лечение на тези болни – байпас от външната каротидна към вътрешната каротидна артерия, макар че доказано подобрява церебралната хемодинамика, не води до намаляване на риска от инсулт [12]. Реваскуларизацията може би има ефект, но само при строго селектирана група от пациенти, при които нарушената церебрална перфузия е доказана с перфузионна CT/ MRI/PET [5]. Друг проблем при субтоталните каротидни стенози е честото им неразпознаване, дължащо се на затруднена интерпретация както с неинвазивни, така и с инвазивни методи на изследване. Същевременно, различаването им е от голяма важност, защото веднъж установени, те повдигат въпроса за нуждата да бъдат лекувани, както и за найподходящия терапевтичен подход – хирургичен, ендоваскуларен или медикаментозен.
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Presence of microbleeds on MRI, however, has some impact but does not significantly increase the risk of bleeding with TL [39, 54].
deterioration by >4 points NIHSS (or equivalent) combined with cerebral haemorrhage within an ischaemic lesion where any mass effect is largely attributed by the haemorrhage” [36]. Presence of microbleeds on MRI, however, has some impact but does not significantly increase the risk of bleeding with TL [39, 54].
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use of TL in less severe AIS or use of low dose t-PA plus better MRI evaluation of the patients.
use of TL in less severe AIS or use of low dose t-PA plus better MRI evaluation of the patients. Results of using 0.6 mg/kg alteplase within 3 h of onset were compatible with data reported for a 0.9 mg/kg dose [52];
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advanced imaging approach with CT (ASPECTS); MRI (a digital atlas using the ASPECTS scoring – measures the stroke severity in an automated fashion and facilitates more objective, sensitive, and potentially more complex scoring); MRI diffusion and perfusion may reveal brain tissue at risk that can be salvaged with TL in individual patients within a 3-hour time window and possibly even longer (grade C evidence) [21, 23, 41, 47, 54, 57];
advanced imaging approach with CT (ASPECTS); MRI (a digital atlas using the ASPECTS scoring – measures the stroke severity in an automated fashion and facilitates more objective, sensitive, and potentially more complex scoring); MRI diffusion and perfusion may reveal brain tissue at risk that can be salvaged with TL in individual patients within a 3-hour time window and possibly even longer (grade C evidence) [21, 23, 41, 47, 54, 57];
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The Desmoteplase in Acute Ischemic Stroke Trial (DIAS): a phase II MRI-based-9-hour
Hacke W, Albers G, Al-Rawi Y, Bogousslawsky J, Davalos A, Eliasziw M, Fisher M, Furlan A, Kaste M, Lees KR, Soehngen M, Warach S. DIAS Study Group. The Desmoteplase in Acute Ischemic Stroke Trial (DIAS): a phase II MRI-based-9-hour
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10. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 6, 2010, No. 2 , , ,

Since 2007, eighteen patients with spinal tumors, diagnoseg by MRI have been treated with ultrasound-guided surgery.
Since 2007, eighteen patients with spinal tumors, diagnoseg by MRI have been treated with ultrasound-guided surgery. Ultrasound anatomy of spinal cord next to the pathologic processes was investigated. Ultrasound exploration was performed during laminectomy on the dural surface in all cases and after the dural opening of the spinal cord surface for intramedullary tumors.
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A good correlation exists between the signal intensity on T1-weighted images of MRI, echographic aspect of the tumor and pathological interaoperative findings.
Intraoperative neurosonography should be used routinely during surgery for spinal tumors in order to reduce the extent of the laminectomy, dural opening and myelotomy. A good correlation exists between the signal intensity on T1-weighted images of MRI, echographic aspect of the tumor and pathological interaoperative findings.
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The aim of this study is to evaluate the role of neurosonography in spinal cord tumor surgery by examining the correlations between the magnetic resonance imaging (MRI), intraoperative neurosonography and surgical evaluation of the actual operative situation.
The aim of this study is to evaluate the role of neurosonography in spinal cord tumor surgery by examining the correlations between the magnetic resonance imaging (MRI), intraoperative neurosonography and surgical evaluation of the actual operative situation.
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All patients were diagnosed by MRI preoperatively and evaluated by neurosonography intraoperatively.
Since 2007, 18 patients (10 women and 8 men) with spinal cord tumors were operated at the Clinic of Neurosurgery in Military Medical Academy, Sofia. The mean age of the patients was 51±19 years. All patients were diagnosed by MRI preoperatively and evaluated by neurosonography intraoperatively.
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There is a distinct correlation between preoperative MRI images and intraoperative neurosonography of macrocysts in ependimomas.
There is a distinct correlation between preoperative MRI images and intraoperative neurosonography of macrocysts in ependimomas. Microcysts are visible only on neurosonography. There is a better visualization of neurinoma microcyst when we use intraoperative ultrasound. Calcium deposits in meningiomas are equally visible on inraoperative ultrasound and T1 images in MRT.
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Extramedullary tumors, particularly neurinomas, may change their position against the reference bone marks, chosen by the surgeon, depending on the patient’s position (usually MRI and operative position of the patient are different) [4, 10].
Mostauthorssupporttheuseofneurosonography as a valuable tool with minimal invasiveness in spinal cord tumor surgery [9, 18]. Even at the stage of initial resection, neurosonography can be used as a preliminary ultrasound inspection of the pathological process, to obtain a minimal/limited surgical opening. Some authors recommend the application of transligamentary sonography prior to initial resection [5]. Extramedullary tumors, particularly neurinomas, may change their position against the reference bone marks, chosen by the surgeon, depending on the patient’s position (usually MRI and operative position of the patient are different) [4, 10]. The incision of dura mater is
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On the MRI, the macrocysts are visualized as hypointense zones on T1and hyperintense on T2-weighted images.
In neurinomas, the presence of macrocysts is due to cystic degeneration within the tumor. This type of degeneration is significantly more frequent in Antony type B neurinomas, in which the stromal component is prevalent. Antony type A neurinoma is usually solid, with poorly expressed stromal component and absent microcysts. On the MRI, the macrocysts are visualized as hypointense zones on T1and hyperintense on T2-weighted images. On the intraoperative sonogram, the macrocysts are presented as hypoechogenic zones [7].
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On MRI, these calcificates are visualized as T1-hypointense zones.
Spinal cord ependymomas are mostly of meningotheliomatous type. In some cases, there are microscopically visible zones of hyaline degeneration, surrounded by calcium deposits and psammoma bodies. On MRI, these calcificates are visualized as T1-hypointense zones. On the intraoperative ultrasonogram these zones are presented as hyperechogenic areas in tumor’s background [12].
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This review summarises diagnostic values of brain MRI and clinical data in different diseases causing bilateral basal ganglia and thalami MRI lesions: toxic, metabolic, vascular, infectious, inflammatory diseases and tumors.
Several diseases may cause non specific MRT abnormalities of the bilateral basal ganglia and thalami. Etiological diagnosis based on brain imaging may be difficult. This review summarises diagnostic values of brain MRI and clinical data in different diseases causing bilateral basal ganglia and thalami MRI lesions: toxic, metabolic, vascular, infectious, inflammatory diseases and tumors.
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Neurobihavioral, CT, MRI and SPECT correlates.
Bogousslavsky J, Ragli F, Delaloye B, Assal L, Uske A. Loss of psychic self –activation with bithalamic infarction. Neurobihavioral, CT, MRI and SPECT correlates.
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Phisiologic intracranial calcification with hyperintensity on MRI.
Dell L, Brown M, Orrison W, Eckel C. Phisiologic intracranial calcification with hyperintensity on MRI. Case raport and experimental model.
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MRI of the brain in Wilson disease: T2 signal loss under therapy.
Engelbrecht V, Schlaug G, Hefter H, Kahn T, Modder U. MRI of the brain in Wilson disease: T2 signal loss under therapy.
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Diagnosis of periventricular ependymal enhancement in MRI in adults.
Guerini H, Helie O, Leveque C, Adem C, Hauret L, Cordoliani YS. Diagnosis of periventricular ependymal enhancement in MRI in adults.
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Midbrain pathology of Wilson´s disease: MRI analysis of three cases.
Hitoshi S, Iwata M,Yoshikava K. Midbrain pathology of Wilson´s disease: MRI analysis of three cases.
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Optic atrophy and cerebral infarcts caused by methanol intoxication: MRI.
Hsu H, Chen Y, Chen F, Lee C, Chou Y, Zimmerman R. Optic atrophy and cerebral infarcts caused by methanol intoxication: MRI.
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Wilson's disease: resolution of MRI lesions following long-term oral zinc therapy.
Huang C, Chu N. Wilson's disease: resolution of MRI lesions following long-term oral zinc therapy.
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Clinical, etiological and MRI correlates.
Kumral E, Evyapan D, Balkir K, Kutluhan S. Bilateral thalamic infarction. Clinical, etiological and MRI correlates.
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MRI findings in neurobehcet´s disease.
Lee S, Yoon P, Park S, Kim D. MRI findings in neurobehcet´s disease.
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Value of MRI findings in Wernicke encephalopathy.
Lenz V, Vargas I, Bin F, Bogorin A, Grebici-Guessoum M, Jacques C. Value of MRI findings in Wernicke encephalopathy.
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Wilson's disease: MRI with clinical correlation.
Magalhaes C, Caramelli P, Menezes R, Bacheschi L, Barbosa E. Wilson's disease: MRI with clinical correlation.
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S. MRI hyperintensities of the temporal lobe and external capsule in patients with CADASIL.
S. MRI hyperintensities of the temporal lobe and external capsule in patients with CADASIL.
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Initial and follow-up brain MRI findings and correlation with the clinical course in Wilson's disease.
Roh K, Lee T, Wie A, Lee B, Park S, Chang K. Initial and follow-up brain MRI findings and correlation with the clinical course in Wilson's disease.
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Wilson's disease: MRI demonstration of cavitations in basal ganglia and thalami.
Sener R. Wilson's disease: MRI demonstration of cavitations in basal ganglia and thalami.
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Brain MRI of chronic alcoholism.
Vargas M, Lenz V, Bin J, Bogorin A, Eid M. Brain MRI of chronic alcoholism.
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Early diagnosis with diffusion W MRI.
Weise J, Krapf H, Kuker W. Bithalamic infarcts as the etiology of acute stupor. Early diagnosis with diffusion W MRI.
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M. The pulvinar sign on MRI in variant CreutzfeldJakob disease.
M. The pulvinar sign on MRI in variant CreutzfeldJakob disease.
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11. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 7, 2011, No. 1 , , ,

Though consensus statements and guidelines recommend structural imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI) as standard techniques in dementia, more attention is currently being paid to functional imaging methods, including positron emission tomography (PET).
Though consensus statements and guidelines recommend structural imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI) as standard techniques in dementia, more attention is currently being paid to functional imaging methods, including positron emission tomography (PET). In recent years PET is increasingly used in clinical neurology to understand disease pathogenesis, to aid diagnosis, and to monitor disease progression and response to treatment [27]. PET with 18F-fluorodeoxyglucose (FDG-PET) assesses regional glucose metabolism in the brain. Applied in subjects with cognitive impairment, it assures increased diagnostic accuracy, helps to establish the diagnosis in preclinical stages and to solve difficult cases [17].
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CT and MRI, known as structural imaging methods, are invaluable when structural brain lesions exist.
CT and MRI, known as structural imaging methods, are invaluable when structural brain lesions exist. However, they often provide normal or non-specific results when pathological alterations are only at a functional level, which is the case of most neurodegenerative diseases, especially in the early stages [24]. Such alterations can be detected by functional methods as PET and single photon emission tomography (SPECT) [2, 12]. These methods use either non-specific markers for metabolism/perfusion, or specific receptor and molecule markers. The latter are attractive for their specificity, but expensive, often hard to obtain, and not all are approved for clinical use. Because of the better resolution, PET tends to outperform perfusion SPECT in the workup of cognitive impairment and dementia [11].
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Brain MRI (fig.
Clinical examination was normal. Neurological examination showed no focal signs. Neuropsychological assessment revealed moderate dementia: MMSE: 15/30, BNT short version: 10/15; 10 words list recall (3 trials): 0/10, 2/10, 4/10; constructional praxis: 8/11; 10 word delayed recall: 1/10, with 2 intrusions; word recognition: not applicable (patient unable to understand task); literal verbal fluency for 1 min (letter М): 0; The four instrumental activities of daily living score (4-IADL): 4/4 points, marked impairment. CERAD depression scale: 0 points, no depression. Brain MRI (fig. 1А) demonstrated cortical atrophy which was prominent in the left temporal lobe. PET/СТ with FDG (fig. 1B) provided evidence for temporal and parietal hypometabolism, more pronounced on the left, suggestive of Alzheimer’s disease.
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Brain MRI (fig.
depression scale: 0 points, no depression. Brain MRI (fig. 2А) demonstrated cortical atrophy. PET/СТ with FDG (fig. 2B) provided evidence for hypometabolism affecting the temporal and parietal lobes bilaterally, on both visual assessment and neuroquantification. An area of minor hypometabolism was found in the posterior cingulum. The findings were described as typical of Alzheimer’s disease.
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MRI;
MRI;
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MRI;
MRI;
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The use of MRI and PET for clinical diagnosis of dementia & investigation of cognitive impairment.
The Alzheimer‘s Association Neuroimaging Workgroup. The use of MRI and PET for clinical diagnosis of dementia & investigation of cognitive impairment. A Consensus Report.
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SPECT has been applied for studying primary progressive aphasia (PPA) together with neuropsychological assessment and MRI [71].
is one of the earliest FNM put into practice. It is used not only to document static images of hypoperfusion in hypofunction or atrophy of specific areas, but also to demonstrate blood flow changes as a result of provoked neuronal activity. Technically and practically admissible brain activation has been registered in standard neuropsychological conditions in healthy individuals [5]. Characteristic areas of hypoperfusion have been described in different dementias. The level of frontotemporal hypoperfusion on SPECT has recently been used as a reference for the assessment of dementia severity and feasibility of the modified clinical dementia rating scale for fronto-temporal lobar degeneration by the Consortium of Mayo Clinic and University of California FTLD-centers [10]. SPECT has been applied for studying primary progressive aphasia (PPA) together with neuropsychological assessment and MRI [71]. In cases of frontotemporal dementia (FTD) presenting with aphasia with neologisms and semantic memory impairment, and amyotrophic lateral sclerosis, developed 2 to 3 years later, SPECT would show bilateral frontal and sometimes anterior temporal hypoperfusion [68, 81].
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Perfusion MRI areas depicts of hypoperfusion due to a specific dysfunction.
allows assessment of cortical activity in nonlesioned brain areas associated with speech errors in aphasia. Specific speech errors are connected a spread cortical activity in aphasia of different type and severity. The production of phonemic errors is attributed to the left posterior perilesional, occipital and temporal areas, while similar activity in the right hemisphere is related to semantic errors [30]. Perfusion MRI areas depicts of hypoperfusion due to a specific dysfunction. The character and origin of speech errors related to interruption of access to semantics or lexical representations can thus be clarified. Relationship exists between the semantic deficit and the dysfunction or stroke of Broadmann area (BA) 22, as well as between semantic errors due to lexical access deficit and hypoperfusion or stroke in the left inferior temporal gyrus, BA 37 [14].
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New evidences of the thesis that naming is supported by a network of brain regions have been found through discriminant and linear regression analysis of diffusion and perfusion MRI showing varying degrees of hypoperfusion in specific target areas.
New evidences of the thesis that naming is supported by a network of brain regions have been found through discriminant and linear regression analysis of diffusion and perfusion MRI showing varying degrees of hypoperfusion in specific target areas. Different components of this network are required for different cognitive processes and representations of complex tasks [24].
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Functional MRI of language in aphasia: a review of the literature and the methodological challenges.
16 Crosson B, McGregor K, Gopinath KS, Conway TW, Benjamin M, Chang YL, Moore AB, Raymer AM, Briggs RW, Sherod MG, Wierenga CE, White KD. Functional MRI of language in aphasia: a review of the literature and the methodological challenges.
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Clinical functional MRI of the language domain in children with epilepsy.
Wilke M, Pieper T, Lindner K, Dushe T, Staudt M, Grodd W, Holthausen H, Krageloh-Mann I. Clinical functional MRI of the language domain in children with epilepsy. Hum Brain Mapp 2010, epub.
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12. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 7, 2011, No. 2 , , ,

The cardiac function was assessed by echocardiography, the muscle activity and conduction velocities of the nerves – by EMG (electromyography) and nerve conduction studies and the structural changes in the hip muscles – by magnetic resonance imaging (MRI).
(MRC) were performed. The cardiac function was assessed by echocardiography, the muscle activity and conduction velocities of the nerves – by EMG (electromyography) and nerve conduction studies and the structural changes in the hip muscles – by magnetic resonance imaging (MRI). The ultrasound characteristics of the skeletal muscles were evaluated by a multimodal colorcoded duplex sonograph (Logic 7, GE – Germany) with a special transducer for real time imaging. The changes of the triceps surae muscle were investigated in a lying position according to a standard protocol during rest and during muscle contraction (spontaneous and induced by electrostimulation). The transducer is positioned perpendicularly on the muscle in order to avoid artifacts. A qualitative and quantitative evaluation of the myosonograms with measurements of the transverse diameter of the lateral head of the muscle in longitudal projection, the inclination of the muscle fibers towards the surface of the aponeurosis and their architectonics were performed by 4D imaging during rest and plantar flexion (spontaneous and induced by electric stimulation). The results were compared to mysononograms of a 27-year-old healthy fe-
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MRI demonstrated a dissociated bilateral symmetrical atrophy of the hip muscles – the adductors were the most severely affected, the dorsal and the medial group of flexors were also involved while quadriceps femoris muscles were relatively preserved (fig. 3).
MRI demonstrated a dissociated bilateral symmetrical atrophy of the hip muscles – the adductors were the most severely affected, the dorsal and the medial group of flexors were also involved while quadriceps femoris muscles were relatively preserved (fig. 3).
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MRI imaging of the myopatic hip muscles shows a dissociated bilateral symmetrical atrophy with a relatively preserved quadriceps femoris muscles.
MRI imaging of the myopatic hip muscles shows a dissociated bilateral symmetrical atrophy with a relatively preserved quadriceps femoris muscles.
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quadriceps, shown by MRI.
[2, 13]. The serum СРК can be slightly increased or normal. The cardiac involvement of the patients encompasses partial or complete AV block, necessitating the implantation of pacemaker, mitral valve prolapses, diastolic dysfunction [2, 16]. Our patient is a double heterozygote of I587T and R246W mutations in the GNE-gene [2, 17], with earlier onset (17 years of age) and mild cardiac dysfunction. The atrophy of hip muscles is dissociated with a relatively presurved m. quadriceps, shown by MRI. Myosonology demonstrates structural and functional changes of the triceps surae muscles due to severe myopathy
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Two large, phase 3 trials – TRANSFORMS and FREEDOMS demonstrated that fingolimod improved the clinical outcome for MS patients – reduced the annualized relapse rate, decreased the risk of confirmed disability progression and reduced the number and volume of brain lesions on MRI images.
(fingolimod), is the first oral drug licensed by the European Medicines Agency as a single disease modifying therapy in highly active relapsing remitting multiple sclerosis (MS). Fingolimod mediates its therapeutic effects through the immune system and directly on the central nervous system (CNS). Fingolimod reduces the recirculation of auto-reactive central memory Tcells and their infiltration in the CNS, where they would cause neurodegeneration. Peripheral lymphocyte count reduction is reversible and reflects the reversible retention of circulating lymphocytes in lymph nodes, but not their depletion. Two large, phase 3 trials – TRANSFORMS and FREEDOMS demonstrated that fingolimod improved the clinical outcome for MS patients – reduced the annualized relapse rate, decreased the risk of confirmed disability progression and reduced the number and volume of brain lesions on MRI images.
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13. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 8, 2012, No. 1 , , ,

Detecting plaques of demyelination on MRI is always accompanied by CMCT prolongation [6].
MEP amplitude changes are probably due to dispersion and desynchronization of descendent impulses through the damaged corticospinal tract or to conduction block. Prolonged CMCT is a result of disturbed action potential conductivity through demyelinated fibers. There is a very good correlation between TMS abnormalities and clinical symptoms – spasticity, hyperreflexes and level of motor disturbances. CMCT is prolonged even in patients with no clinical data for motor disturbances. Some authors use this method for estimation of disease progression and prognosis [14]. Detecting plaques of demyelination on MRI is always accompanied by CMCT prolongation [6]. From non-standard TMS techniques, the
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Combining TMS with functional MRI optimizes surgery and reduces the risk of postoperative deficit [39, 40].
TMS is used for preoperative assessment of specific cortical areas (identification of the dominant hemisphere, localization of speech or motor areas), and intraoperative monitoring of corticospinal tract. Combining TMS with functional MRI optimizes surgery and reduces the risk of postoperative deficit [39, 40]. Application of high-frequency rTMS at lower frontal lobe of the dominant hemisphere leads to "speech arrest", which allows precise localization of cortical speech areas [14].This test is used as an alternative to the Wada test in preoperative preparation for temporal lobectomy. In spinal cord surgery the function of anterior and lateral tracts is monitored by TMS in contrast to somatosensory evoked potentials (SSEP) evaluating the conductivity of posterior tracts. The combined use of both methods, monitoring afferent and efferent conduction pathways, significantly reduces postoperative risk. The negative influence of inhalatory anesthetics on MEP generation at this stage is overcome by the application of
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Recently, in scientific practice combined functional MRI (fMRT) and neuronavigated TMS were introduced.
Recently, in scientific practice combined functional MRI (fMRT) and neuronavigated TMS were introduced. This allowed precise localization of areas subject to stimulation and evaluation of TMS-induced anatomical and functional effects on the brain. TMS-induced metabolic changes can be measured using PET and changes in blood oxygen saturation – with fMRT. Both methods have short-term effectiveness: seconds for fMRT and up to five minutes for PET, so that brain responses in the first 10 ms after the stimulus are ignored. Promising prospects for solving this problem is the simultaneous application of TMS and EEG, offering high resolution in time and evaluation of cortical reactivity and connections [45]. Induced by TMS EEG responses are with specific latency and high spatial and temporal resolution.
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14. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 2, 2012, No. 2 , , ,

The US method provides advantage compared to EMG or MRI/CT, since the muscle motion could be better detected and quantified in terms of velocity and accelerations as well as synchronicity of muscle contraction.
Using high resolution B-Mode the physiological and pathological structures of the muscle tissue could be visualized. US of muscles was first used during examinations of athletes to detect muscle injuries like bleedings or disruption after exercise. Even more, the position of needle electrodes for biopsy or injections of medications – e.g. botulinum toxins or local anesthetics opens new quality improvement for the treatment of patients. Using tissue velocity imaging (TVI) we are able to investigate the dynamics of movements in identified muscles. The US method provides advantage compared to EMG or MRI/CT, since the muscle motion could be better detected and quantified in terms of velocity and accelerations as well as synchronicity of muscle contraction. This will allow not only the monitoring of muscle tissue volume during processes of atrophy or after exercise, but also monitoring the effect of medicalor physiotherapies on movements e.g. during rehabilitation or sports.
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Ultrasound application in other than neurological indication extended more and more the diagnostic field in competition to CT/MRI e.g.
beside the descriptions of plaque morphology and risk factors, grading of carotid stenosis, microemboli detection, acute stroke managment, brain tissue imaging and cerebral autoregulation. The technical development of the US equipment demonstrates further improvements of the image quality and fast processing leading to increased spacial and temporal resolution, improved contrast imaging, elasthography and easy to use application to support the application of the US technology even in the daily routine with high quality. Ultrasound application in other than neurological indication extended more and more the diagnostic field in competition to CT/MRI e.g. analysis of tumour tissue using ultrasound contrast agents, searching for lymph node pathology and future aspects of local drug application by loaded microbubbles and treatment via sonovaporation [14].
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MRI,
MRI,
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MRI, MRI venography and color coded duplex sonography were performed.
The study was performed in a 53-year-old patient with headache, nausea and right sided hemiparesis a few days before hospitalization. MRI, MRI venography and color coded duplex sonography were performed.
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On MRI and MRI venography multifocal subcortical hemorrhages from cerebral venous thrombosis of sinus sagittalis superior and right sinus transversus were seen.
On MRI and MRI venography multifocal subcortical hemorrhages from cerebral venous thrombosis of sinus sagittalis superior and right sinus transversus were seen.
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Neuroimaging examination of the brain was conducted by 1.5 Tesla MRI (GE HTX SigmaUSA).
Neuroimaging examination of the brain was conducted by 1.5 Tesla MRI (GE HTX SigmaUSA).
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MRI and MPA in the presence of multiple hemorrhagic areas with perifocal edema, located bilaterally in parietal and parasagittal zones.
MRI and MPA in the presence of multiple hemorrhagic areas with perifocal edema, located bilaterally in parietal and parasagittal zones.
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Emergency MRI and MRA were performed after the patient’s clinical deterioration, establishing 9 hemorrhagic areas from 10 to 21 mm with perifocal edema, located bilaterally in parietal and parasagittal zones (fig. 1).
Emergency MRI and MRA were performed after the patient’s clinical deterioration, establishing 9 hemorrhagic areas from 10 to 21 mm with perifocal edema, located bilaterally in parietal and parasagittal zones (fig. 1).
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15. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 9, 2013, No. 1 , , ,

Many investigators tried to replicate Zamboni’s results with duplex sonography, MRI, and catheter angiography.
In 2006, Zamboni re-introduced the concept that chronic impaired venous outflow of the CNS is associated with multiple sclerosis (MS), coining the term of chronic cerebrospinal venous insufficiency (“CCSVI”). The diagnosis of “CCSVI” is based on sonographic criteria, which he found exclusively fulfilled in MS. The concept proposes that chronic venous outflow failure is associated with venous reflux and congestion and leads to iron deposition, thereby inducing neuroinflammation and degeneration. The revival of this concept has generated major interest in media and patient groups, mainly driven by the hope that endovascular treatment of “CCSVI” could alleviate MS. Many investigators tried to replicate Zamboni’s results with duplex sonography, MRI, and catheter angiography. The data obtained here do generally not support the “CCSVI” concept. Moreover, there are no methodologically adequate studies to prove or disprove beneficial effects of endovascular treatment in MS. This review gives a comprehensive overview of the methodological flaws of the ultrasound based “CCSVI” concept. In our view, there is currently no basis to diagnose or treat “CCSVI” in the care of MS patients.
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Subsequently, they reported improvement in the Multiple Sclerosis Functional Composite (MSFC) in relapsing remitting MS and a reduction of Gadolinium enhancing lesions on brain MRI during a mean follow-up of 18 months in a small monocentric open angioplastic intervention study [66].
ported a correlation of the clinical course of MS with specific patterns of venous obstructions [9]. Subsequently, they reported improvement in the Multiple Sclerosis Functional Composite (MSFC) in relapsing remitting MS and a reduction of Gadolinium enhancing lesions on brain MRI during a mean follow-up of 18 months in a small monocentric open angioplastic intervention study [66]. “CCSVI” and its presumed efficacious therapeutic approach termed “liberation treatment” caused enormous interest in the scientific community, amongst patient support groups and in the media. Several clinical trials on angioplasty have started since, and numerous desperate MS patients seek relief from their incurable disease through questionable medical procedures. However, in the meantime the number of publications that refute the “CCSVI” hypothesis has far exceeded that of its supporters. This review aims to analyse and critically comment on methodical aspects of “CCSVI” in the context of (patho-)physiological plausibility, which refers mainly to color-coded duplex ultrasonography (US), which is the only method according to Zamboni to define “CCSVI”.
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tural dependency of cerebro-venous outflow has also been demonstrated in MRI investigations41 and was already observed using a conventional catheter approach [18, 27].
tural dependency of cerebro-venous outflow has also been demonstrated in MRI investigations41 and was already observed using a conventional catheter approach [18, 27].
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Quantifying the effect of posture on intracranial physiology in humans by MRI flow studies. J
Alperin N, Lee SH, Sivaramakrishnan A, Hushek SG. Quantifying the effect of posture on intracranial physiology in humans by MRI flow studies. J
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16. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 9, 2013, No. 2 , , ,

Multisequence MRI is able to quantify carotid plaque components.
Symptomatic patients with microembolic signals (MES), assessed by TCD, have been shown to be at high risk for developing ipsilateral stroke. Whether MES positive asymptomatic patients also are at increased risk has not been clarified. The use of ultrasound contrast agents may be helpful in determining plaque surface and plaque neovascularization. Multisequence MRI is able to quantify carotid plaque components. The use of a contrast agent improves quantification of total plaque burden, and contrast between fibrous cap and lipid core. Dynamic contrast-enhanced MRI allows assessment of plaque neovascularization.
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Dynamic contrast-enhanced MRI allows assessment of plaque neovascularization.
Symptomatic patients with microembolic signals (MES), assessed by TCD, have been shown to be at high risk for developing ipsilateral stroke. Whether MES positive asymptomatic patients also are at increased risk has not been clarified. The use of ultrasound contrast agents may be helpful in determining plaque surface and plaque neovascularization. Multisequence MRI is able to quantify carotid plaque components. The use of a contrast agent improves quantification of total plaque burden, and contrast between fibrous cap and lipid core. Dynamic contrast-enhanced MRI allows assessment of plaque neovascularization.
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These initial studies have shown the potential of USPIO -enhanced MRI, 18F-FDG PET, IL2 scintigraphy, and low-density lipoprotein scintigraphy to identify inflammation, the potential of annexin A5 scintigraphy to identify cell death, and platelet scintigraphy to depict plaque thrombosis.
Currently, there are few in vivo human studies on functional imaging of carotid plaques. These initial studies have shown the potential of USPIO -enhanced MRI, 18F-FDG PET, IL2 scintigraphy, and low-density lipoprotein scintigraphy to identify inflammation, the potential of annexin A5 scintigraphy to identify cell death, and platelet scintigraphy to depict plaque thrombosis. Biomarkers have been shown to improve prediction independent of conventional risk factors. High sensitivity C-reactive protein (hs-CRP) and lipoprotein-phospholipase A2 (PLA2) are two such candidates
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The upcoming MRI-ultrasound fusion imaging techniques that are available already today with advanced ultrasound systems allow the ultrasound-guided targeting also of small deep muscles such as the longus colli muscle in patients with antecollis, and the piriformis muscle in patients suffering from the piriformis syndrome.
Ultrasound may be helpful to validate already established injection techniques or when learning the correct injection technique. Ultrasound-guided BoNT injection has been recommended as a standard procedure in treatment of lower leg spasticity in children with cerebral palsy. In recent years, this technique has been increasingly used also for the exact targeting of BoNT injection in single forearm muscles (e.g. the flexor digitorum superficialis or the flexor digitorum profundus muscle of single fingers) of patients with writers cramp or with mild post-stroke spasticity. An emerging application is the ultrasound-guided BoNT injection into deep cervical and nuchal muscles in patients with cervical dystonia, such as the scalene muscles, the longissimus cervicis muscle, and the obliquus capitis inferior muscle. The upcoming MRI-ultrasound fusion imaging techniques that are available already today with advanced ultrasound systems allow the ultrasound-guided targeting also of small deep muscles such as the longus colli muscle in patients with antecollis, and the piriformis muscle in patients suffering from the piriformis syndrome.
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duplex sonography, evoked potentials, MRI.
duplex sonography, evoked potentials, MRI.
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These findings are in favor of an independent influence of obstructive sleep apnea on carotid artery atherosclerosis and asymtomatic changes of the brain in performet MRI.
These findings are in favor of an independent influence of obstructive sleep apnea on carotid artery atherosclerosis and asymtomatic changes of the brain in performet MRI.
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media thickness, obstructive sleep apnea, MRI.
media thickness, obstructive sleep apnea, MRI.
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Infarct size was a maximal diameter of acute lesion based on diffusion weighted MRI.
We included 69 patients with acute lacunar stroke who completed TCD. We used mean PI value of both MCA for analysis. Infarct size was a maximal diameter of acute lesion based on diffusion weighted MRI.
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Neuroimaging included non-contrast CT or MRI, diffusion and angio MRI.
Two men and one woman, mean age of 61.6, two with MCA occlusion and one with posterior AIS, were treated. Clinical outcome was assessed according to NIHSS and mRS on day 1, 30 and 90. Neuroimaging included non-contrast CT or MRI, diffusion and angio MRI. All patients underwent cerebral angiography and met criteria for endovascular TL. Transcranial duplex scanning was used for haemodynamic assessment of the occlusion and recanalization. Actiyse was infused supraselectively via microcatheter in a mean dose of 38.3 mg. TICI score was documented at the end of the procedure. Post-procedural I.V.
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Diffusion MRI demonstrated large MCA territory lesion > 1/3 in 1 patient, and small zones in 2 other.
symptoms onset to start of IAT was 175 min. Mean initial NIHSS was 14.6. Diffusion MRI demonstrated large MCA territory lesion > 1/3 in 1 patient, and small zones in 2 other. TICI scores were 2b, 3, 1. None of the patients had iatrogenic haemorrhage. Ultrasound monitoring showed recanalization immediately after the procedure in 2 patients, and 3 hours later in 1 patient. On control vascular imaging, that result was stable on the second day. Control CT revealed an infarct area with edema only in one patient.
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All patients were evaluated for the development of neurological symptoms and with MRI flow study 6 months after surgery.
measure CSF flow after subocciptal craniotmy. Patients with CSF flow above 3 cm/s were not subjected to dural opening. Patients with CSF flow below 3 cm/s were submitted to duroplasty technique. All patients were evaluated for the development of neurological symptoms and with MRI flow study 6 months after surgery.
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A 31-year-old man with amaurosis after eye blast trauma at the age of 17, underwent multiple operations and different eye-procedures (including a silicon vitreous filling) was studied by parallel application of multimodal 2D/3D/4D ultrasound eye-imaging, electroencephalography, visual and auditory evoked potentials, CT and MRI.
A 31-year-old man with amaurosis after eye blast trauma at the age of 17, underwent multiple operations and different eye-procedures (including a silicon vitreous filling) was studied by parallel application of multimodal 2D/3D/4D ultrasound eye-imaging, electroencephalography, visual and auditory evoked potentials, CT and MRI.
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17. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 10, 2014, No. 1 , , ,

the age of 17, underwent multiple operations and different eye-procedures (including a silicon vitreous filling) was studied by parallel application of multimodal 2D/3D/4D ultrasound eye-imaging, electroencephalography, visual and auditory evoked potentials and MRI.
the age of 17, underwent multiple operations and different eye-procedures (including a silicon vitreous filling) was studied by parallel application of multimodal 2D/3D/4D ultrasound eye-imaging, electroencephalography, visual and auditory evoked potentials and MRI.
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The study shows complete match etween the ultrasound and the MRI imaging of the ocular structures in our patient.
last trauma [7]. The application of multimodal 2D/3D/4D sonography with B-flow imaging of the ophthalmic lood vessels increases the diagnostic value of the routine B-scan and gives additional information a out the topic, severity and characteristics of the pathological process and its vascularization [1, 14]. The study shows complete match etween the ultrasound and the MRI imaging of the ocular structures in our patient.
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Вrain MRI.
Вrain MRI. Normal brain parenchyma, ocular muscles and occipital cortex (
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MRI of the brain – ischemic stroke in MCA territory with hemorrhagic transformation
MRI of the brain – ischemic stroke in MCA territory with hemorrhagic transformation
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Potential mechanisms studied by MRI.
Potential mechanisms studied by MRI.
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18. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 10, 2014, No. 2 , , ,

Since subcortical VaD sometimes presents gradual progression, extrapyramidal signs, depression and leukoaraiosis or white matter abnormality on CT or MRI which are also frequently observed in AD, it is probably the most difficult to discriminate clinically from AD.
proposed to diagnose patients with MCI. An important issue in the early diagnosis of AD is also the differential diagnosis with Vascular dementia (VaD). Especially the new concept of Subcortical VCI will be discussed. Since subcortical VaD sometimes presents gradual progression, extrapyramidal signs, depression and leukoaraiosis or white matter abnormality on CT or MRI which are also frequently observed in AD, it is probably the most difficult to discriminate clinically from AD. In this context, a better understanding of neuropsychological differences between MCI and VCI may have important implications for the differential diagnosis of these disorders.
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Since subcortical VaD sometimes presents gradual progression, extrapyramidal signs, depression and leukoaraiosis or white matter abnormality on CT or MRI which are also frequently observed in AD, it is probably the most difficult to discriminate clinically from AD.
An important issue in the early diagnosis of VaD is also the differential diagnosis with AD. Since subcortical VaD sometimes presents gradual progression, extrapyramidal signs, depression and leukoaraiosis or white matter abnormality on CT or MRI which are also frequently observed in AD, it is probably the most difficult to discriminate clinically from AD. In this context, a better understanding of neuropsychological differences between VaD and AD may have important implications for the differential diagnosis of these disorders.
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Similar generalization of cerebral activity was also reported with functional MRI during cognitive tasks in elderly people [6].
While age ranging from 10 – 60 years did not affect NVC in a functional transcranial Doppler (TCD) study with a visual stimulation task and monitoring posterior cerebral artery [17], another study involving young and old subjects that assessed NVC in the anterior and posterior cerebral arteries during visual and executive function tasks found that overall NVC seems to be altered with aging [21]. While the younger group showed taskspecific flow activation in one territory at a time, the older group showed a generalized increase in blood flow in both the territories in response to both tasks suggesting generalization of cerebral activity to compensate for age related loss of region specific function. Similar generalization of cerebral activity was also reported with functional MRI during cognitive tasks in elderly people [6].
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MRI measures of middle cerebral artery diameter in
Serrador JM, Picot PA, Rutt BK, Shoemaker JK, Bondar RL. MRI measures of middle cerebral artery diameter in
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There is insufficient information for the diagnosis of VaD (eg, clinical symptoms suggest the presence of vascular disease, but noCT/MRI studies are available).
There is insufficient information for the diagnosis of VaD (eg, clinical symptoms suggest the presence of vascular disease, but noCT/MRI studies are available).
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There is insufficient information for the diagnosis of VaMCI (eg, clinical symptoms suggest the presence of vascular disease, but noCT/MRI studies are available).
There is insufficient information for the diagnosis of VaMCI (eg, clinical symptoms suggest the presence of vascular disease, but noCT/MRI studies are available).
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Neuroradiological procedures may be of benefit in assessing early morphological changes and are usually based on computed tomography (CT) and magnetic resonance imaging (MRI) findings.
The initial diagnostic approach to cognitive changes with age includes a clinical assessment and a neuropsychological evaluation [18]. Neuroradiological procedures may be of benefit in assessing early morphological changes and are usually based on computed tomography (CT) and magnetic resonance imaging (MRI) findings. Identification of early stages of microangiopathicatherosclerotic changes of the small brain blood vessels can be assessed by means of neuro-
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highly variable in terms of size, location, aetiology and thus MRI signal properties.
highly variable in terms of size, location, aetiology and thus MRI signal properties. All were located either at the motor cortical areas or were related to leg pyramidal fibers.
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The follow-up of the recovery process of stroke patients from the very acute stage onwards was performed using a multimodal approach including lesion characterization with MRI and neurophysiologic and physical functioning evaluations.
The follow-up of the recovery process of stroke patients from the very acute stage onwards was performed using a multimodal approach including lesion characterization with MRI and neurophysiologic and physical functioning evaluations. The intervention group received intensive gait-oriented rehabilitation for 3 weeks whereas the patients in the control group followed the conventional treatment path. The focus of this study was on assessing the motor tract physiology after stroke. The conduction properties of the unimpaired descending motor pathways to the affected side muscles during the
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Stroke is a dynamic disease, consequently static neuroimaging studies (CT, MRI) characterize this process only partially; ultrasound monitoring in parallel with clinical evaluation offer in-
Stroke is a dynamic disease, consequently static neuroimaging studies (CT, MRI) characterize this process only partially; ultrasound monitoring in parallel with clinical evaluation offer in-
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Two tales: hemorrhagic transformation but not parenchymal hemorrhage after thrombolysis is related to severity and duration of ischemia: MRI study of acute stroke patients treated with intravenous tissue plasminogen activator within 6 hours.
Thomalla G, Sobesky J, Kohrmann M, et al. Two tales: hemorrhagic transformation but not parenchymal hemorrhage after thrombolysis is related to severity and duration of ischemia: MRI study of acute stroke patients treated with intravenous tissue plasminogen activator within 6 hours.
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Modern TCS systems have a possibility to display deep brain structures with a very high lateral and axial resolution similar to that of magnetic resonance imaging (MRI) in clinical applications [6].
Structural abnormality of the midbrain raphe displayed as reduced echogenicity or invisible brainstem raphe (BR) was found in patients with unipolarand depression associated with some other neurological diseases [2, 3, 4, 5]. Modern TCS systems have a possibility to display deep brain structures with a very high lateral and axial resolution similar to that of magnetic resonance imaging (MRI) in clinical applications [6].
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Observed TCS changes were also present in some of patients with normal brain MRI [5].
[5] investigated 21 consecutive WD patients (18 with neurological form of the disease), and found increased LN echogenicity on at least one side in all assessed neurologically symptomatic and in 2 of the 3 patients with hepatic form of WD. Proposed explanation for LN hyperechogenicity in patients with either neurologic or hepatic form of WD, was increased copper content. SN hyperechogenicity was found in almost half of WD patients in the same study (10 out of 21) without ventricular system dilatation. Observed TCS changes were also present in some of patients with normal brain MRI [5].
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Our group conducted MRI parallel to TCS in 5 unrelated patients with pantothenate kinase-associated neurodegeneration (PKAN), caused by PANK2 mutations [19].
Results of both TCS studies in WD patients, confirmed the ability of the method for early detection of trace metals in the basal ganglia (probably copper and possibly iron and manganese). Similar findings were observed in some other neurodegenerative diseases with trace metals accumulation. Our group conducted MRI parallel to TCS in 5 unrelated patients with pantothenate kinase-associated neurodegeneration (PKAN), caused by PANK2 mutations [19]. “All patients in our study had an eye of the tiger sign on MRI. Hypointense lesions on the T2-weighted MRI images were restricted to the globus pallidus (GP) and SN. TCS also revealed bilateral hyperechogenic areas restricted to the LN and SN, with normal values of the third ventricle diameter. Both TCS and MRI findings in PKAN patients are in accordance with the pathological findings that accumulation of iron, even in advanced cases, is restricted to the GP and SN, suggesting selective
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“All patients in our study had an eye of the tiger sign on MRI.
Results of both TCS studies in WD patients, confirmed the ability of the method for early detection of trace metals in the basal ganglia (probably copper and possibly iron and manganese). Similar findings were observed in some other neurodegenerative diseases with trace metals accumulation. Our group conducted MRI parallel to TCS in 5 unrelated patients with pantothenate kinase-associated neurodegeneration (PKAN), caused by PANK2 mutations [19]. “All patients in our study had an eye of the tiger sign on MRI. Hypointense lesions on the T2-weighted MRI images were restricted to the globus pallidus (GP) and SN. TCS also revealed bilateral hyperechogenic areas restricted to the LN and SN, with normal values of the third ventricle diameter. Both TCS and MRI findings in PKAN patients are in accordance with the pathological findings that accumulation of iron, even in advanced cases, is restricted to the GP and SN, suggesting selective
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Hypointense lesions on the T2-weighted MRI images were restricted to the globus pallidus (GP) and SN.
Results of both TCS studies in WD patients, confirmed the ability of the method for early detection of trace metals in the basal ganglia (probably copper and possibly iron and manganese). Similar findings were observed in some other neurodegenerative diseases with trace metals accumulation. Our group conducted MRI parallel to TCS in 5 unrelated patients with pantothenate kinase-associated neurodegeneration (PKAN), caused by PANK2 mutations [19]. “All patients in our study had an eye of the tiger sign on MRI. Hypointense lesions on the T2-weighted MRI images were restricted to the globus pallidus (GP) and SN. TCS also revealed bilateral hyperechogenic areas restricted to the LN and SN, with normal values of the third ventricle diameter. Both TCS and MRI findings in PKAN patients are in accordance with the pathological findings that accumulation of iron, even in advanced cases, is restricted to the GP and SN, suggesting selective
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Both TCS and MRI findings in PKAN patients are in accordance with the pathological findings that accumulation of iron, even in advanced cases, is restricted to the GP and SN, suggesting selective
Similar findings were observed in some other neurodegenerative diseases with trace metals accumulation. Our group conducted MRI parallel to TCS in 5 unrelated patients with pantothenate kinase-associated neurodegeneration (PKAN), caused by PANK2 mutations [19]. “All patients in our study had an eye of the tiger sign on MRI. Hypointense lesions on the T2-weighted MRI images were restricted to the globus pallidus (GP) and SN. TCS also revealed bilateral hyperechogenic areas restricted to the LN and SN, with normal values of the third ventricle diameter. Both TCS and MRI findings in PKAN patients are in accordance with the pathological findings that accumulation of iron, even in advanced cases, is restricted to the GP and SN, suggesting selective
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Contemporary ultrasound systems allow highresolution transcranial imaging of small echogenic deep intracranial structures similarly as MRI: a phantom study.
Walter U, Kanowski M, Kaufmann J, Grossmann A, Benecke R, Niehaus L. Contemporary ultrasound systems allow highresolution transcranial imaging of small echogenic deep intracranial structures similarly as MRI: a phantom study.
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During the last years different magnetic-resonance imaging (MRI) techniques for examination of the cerebral VMR: blood oxygen level dependent MRI (BOLD MRI) with estimation of the cerebral oxygenation, arterial spin labeling MRI (ASL – MRI) with estimation of the arterial blood flow [19] and quantitative MRI angiography [3] have been used.
(PET), single photon emission comuterized tomography (SPECT). These investigations are more expensive, they are associated with radiation and often reveal variable results. During the last years different magnetic-resonance imaging (MRI) techniques for examination of the cerebral VMR: blood oxygen level dependent MRI (BOLD MRI) with estimation of the cerebral oxygenation, arterial spin labeling MRI (ASL – MRI) with estimation of the arterial blood flow [19] and quantitative MRI angiography [3] have been used. BOLD MPI gives possibility for cerebral VMR mapping and for evaluation of its regional heterogeneity. Comparative studies have shown good correlations between the results of the MRI and TCD tests when examining the cerebral VMR in one and the same patient. When comparing the parallel investigation of the VMR with PET and TCD however, coincidence of the results in only half of the patients with symptomatic occlusions of the internal carotid arteries was found [24].
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Comparative studies have shown good correlations between the results of the MRI and TCD tests when examining the cerebral VMR in one and the same patient.
(PET), single photon emission comuterized tomography (SPECT). These investigations are more expensive, they are associated with radiation and often reveal variable results. During the last years different magnetic-resonance imaging (MRI) techniques for examination of the cerebral VMR: blood oxygen level dependent MRI (BOLD MRI) with estimation of the cerebral oxygenation, arterial spin labeling MRI (ASL – MRI) with estimation of the arterial blood flow [19] and quantitative MRI angiography [3] have been used. BOLD MPI gives possibility for cerebral VMR mapping and for evaluation of its regional heterogeneity. Comparative studies have shown good correlations between the results of the MRI and TCD tests when examining the cerebral VMR in one and the same patient. When comparing the parallel investigation of the VMR with PET and TCD however, coincidence of the results in only half of the patients with symptomatic occlusions of the internal carotid arteries was found [24].
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Improvement of the investigated with BOLD –MRI impaired VMR in patients with high-grade stenoses after carotid endarterectomy is reported [10].
It is found that the measurement of the VMR could be used for evaluation of the therapeutic interventions in patients with carotid disease. Improvement of the investigated with BOLD –MRI impaired VMR in patients with high-grade stenoses after carotid endarterectomy is reported [10]. In similar patients the subgroup with reduced VMR in the MCA is the only independent risk factor for new ischemic accident after carotid stenting [18]. A study in patients with subarachnoid hemorrhage shows that the abnormal VMR after СО
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Disease Using MRI BOLD and ASL Techniques.
Disease Using MRI BOLD and ASL Techniques.
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19. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 11, 2015, No. 1 , , ,

Ultrasound methods can be used as a screening tool for a selection of patients undergoing lumbar puncture, CT or MRI.
Ultrasound methods can be used as a screening tool for a selection of patients undergoing lumbar puncture, CT or MRI.
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20. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 11, 2015, No. 2 , , ,

P13 Basilar Artery Fenestration – Correlative MRI and Neurosonographic Studies.
P13 Basilar Artery Fenestration – Correlative MRI and Neurosonographic Studies.
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Brain MRI confirmed the CT scan finding.
At admission, his blood pressure was 140/90 mmHg, regular heart rate of 95/min, central right facial palsy, aphasia with right-sided hemiplegia. Initial brain CT showed a small post-ischemic zone in the left parietal lobe. Doppler ultrasound of carotid arteries was normal. A repeated CT brain after 48 hours showed a large left middle cerebral artery infarction with focal areas of hemorrhagic transformation. Echocardiography revealed a septoapical aneurysm with akinetic walls, a mobile thrombus in the apical region and thrombi in the left ventricle. Brain MRI confirmed the CT scan finding. Multidisciplinary team of a neurologist, cardiologist and transfusiologist discussed over the decision whether to use anticoagulant therapy.
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The Magnetic Resonance Imaging (MRI) of brain found one ischemic zone in the left thalamus, CT angiography of cerebral blood vessels and Doppler ultrasound of carotid and peripheral arteries were normal.
He was treated with intravenous (iv) fibrinolytic therapy with recombinant tissue plasminogen activator r-tPA (Actilyse) 90mg total dose. At the first 24 hours he had stable vital parameters. The control brain CT scan was normal. In the next days his neurological condition became better with mild weakness of the right extremities. Several tests were made. The Magnetic Resonance Imaging (MRI) of brain found one ischemic zone in the left thalamus, CT angiography of cerebral blood vessels and Doppler ultrasound of carotid and peripheral arteries were normal. Echocardiography showed a thinning central part of
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MRI, MRI venography and color coded duplex sonography were done.
The study was performed in a 53-years old patient with headache, nausea, right side hemiparesis from a few days before hospitalization. MRI, MRI venography and color coded duplex sonography were done.
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On MRI multifocal subcortical hemorrhages by cerebral venous thrombosis of sinus sagittalis superior and the right sinus transversus were detected.
On MRI multifocal subcortical hemorrhages by cerebral venous thrombosis of sinus sagittalis superior and the right sinus transversus were detected.
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BASILAR ARTERY FENESTRATION – CORRELATIVE MRI AND NEUROSONOGRAPHIC STUDY
BASILAR ARTERY FENESTRATION – CORRELATIVE MRI AND NEUROSONOGRAPHIC STUDY
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M-TEX MDL EOOD, Imaging MRI Laboratory, University Emergency Hospital “Pirogov”,
M-TEX MDL EOOD, Imaging MRI Laboratory, University Emergency Hospital “Pirogov”,
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with brain MRI/MRA and multimodal neurosonography.
with brain MRI/MRA and multimodal neurosonography.
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Imaging (MRI/MPA and ultrasonic) methods are useful for non-invasive diagnosis of basilar artery fenestration, which in the past was proved only by conventional cerebral angiography or autopsy.
Imaging (MRI/MPA and ultrasonic) methods are useful for non-invasive diagnosis of basilar artery fenestration, which in the past was proved only by conventional cerebral angiography or autopsy.
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basilar artery fenestration, MRI, neurosonography.
basilar artery fenestration, MRI, neurosonography.
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For the final diagnosis prospective clinical and neuroimaging investigations (2D/3D/4D multimodal neurosonology, CT and MRI of the head) were performed.
The present report describes a 35-year-old man with a history of intermittent pain in the left retrobulbar area lasting approximately six months. The disease debuted with a general infectious syndrome, leftsided exophthalmos with transient visual disturbances and local inflammation of the conjunctiva. The condition was considered initially as conjunctivitis, and later – as TolosaHunt syndrome, which was successfully treated with eye drops, nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics and three courses of corticosteroids. For the final diagnosis prospective clinical and neuroimaging investigations (2D/3D/4D multimodal neurosonology, CT and MRI of the head) were performed.
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Tolosa-Hunt syndrome, CT, MRI, ultrasound.
Tolosa-Hunt syndrome, CT, MRI, ultrasound.
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Parallel clinical, neuropsychological and neuroimaging studies (MRI and MRI tractography) were conducted in a 23-years old patient with proved DCC.
Parallel clinical, neuropsychological and neuroimaging studies (MRI and MRI tractography) were conducted in a 23-years old patient with proved DCC. The results were compared to a brain MRI of a clinically healthy person of the same age.
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The results were compared to a brain MRI of a clinically healthy person of the same age.
Parallel clinical, neuropsychological and neuroimaging studies (MRI and MRI tractography) were conducted in a 23-years old patient with proved DCC. The results were compared to a brain MRI of a clinically healthy person of the same age.
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The brain MRI visualized the typical DCC changes – lack of part of the truncus and the whole splenium, parallel direction of lateral ventricles – “racing car” sign, dorsal communication of the third ventricle with the interhemispheric fissure, dilated Meckel cavities and medially dislocated carotid siphons.
The patient had one febrile seizure in the early childhood followed by antiepileptic medical treatment for many years. Because of his delayed neuropsychological development and severe memory deficiency, he hardly finished his secondary education. According to his father he suffered from headache, had poor vocabulary background and impaired movement coordination. The clinical assessment showed obvious left facial hypotrophy without any other abnormalities. The neurological status revealed apraxia of the upper limbs and the neuropsychological studies – mild cognitive deficiency. The brain MRI visualized the typical DCC changes – lack of part of the truncus and the whole splenium, parallel direction of lateral ventricles – “racing car” sign, dorsal communication of the third ventricle with the interhemispheric fissure, dilated Meckel cavities and medially dislocated carotid siphons. These findings were in contrast with the brain MRI of the healthy control.
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These findings were in contrast with the brain MRI of the healthy control.
Because of his delayed neuropsychological development and severe memory deficiency, he hardly finished his secondary education. According to his father he suffered from headache, had poor vocabulary background and impaired movement coordination. The clinical assessment showed obvious left facial hypotrophy without any other abnormalities. The neurological status revealed apraxia of the upper limbs and the neuropsychological studies – mild cognitive deficiency. The brain MRI visualized the typical DCC changes – lack of part of the truncus and the whole splenium, parallel direction of lateral ventricles – “racing car” sign, dorsal communication of the third ventricle with the interhemispheric fissure, dilated Meckel cavities and medially dislocated carotid siphons. These findings were in contrast with the brain MRI of the healthy control.
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Several publications demonstrated that signal increase in the cerebral cortex, caudate nucleus and putamen on diffusionweighted imaging (DWI) and fluid attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) is useful in diagnosis of sporadic CJD.
The diagnosis of sporadic Creutzfeldt-Jakob disease (CJD) is still made on clinical grounds, with rapidly progressive dementia and electroencephalogram (EEG) changes as hallmarks, while definite confirmation requires neuropathological evaluation. Several publications demonstrated that signal increase in the cerebral cortex, caudate nucleus and putamen on diffusionweighted imaging (DWI) and fluid attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) is useful in diagnosis of sporadic CJD. Transcranial B-mode sonography (TCS) enables visualization of different tissue echogenicity, which can be associated with changes in cerebral metabolism of various metals, one of potential mechanisms of brain damage in CJD.
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We report a 63-year-old woman with typical clinical presentation of sporadic CJD, in whom one month after the disease onset brain MRI revealed diffuse cortical but no obvious basal ganglia involvement.
We report a 63-year-old woman with typical clinical presentation of sporadic CJD, in whom one month after the disease onset brain MRI revealed diffuse cortical but no obvious basal ganglia involvement. However, TCS depicted moderate hyperechogenicity of both lentiform nuclei. Rapid disease progression led to patient’s death two months later.
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In a subpopulation of CJD patients TCS may reveal changes not detected with MRI scans and therefore provide additional information useful for pre-mortem diagnosis.
In a subpopulation of CJD patients TCS may reveal changes not detected with MRI scans and therefore provide additional information useful for pre-mortem diagnosis. Due to common availability and easy applicability, we propose the role of TCS to be investigated in a larger series of CJD cases. TCS hyperechogenicity may be reflecting metal homeostasis changes in CJD.
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21. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 12, 2016, No. 1 , , ,

The indications for selecting patients suitable for mechanical thrombectomy are associated with changes in imaging studies (computed tomography /CT/ and/or CT-angiography or magnetic resonance imaging /MRI/ of the head and/or MR angiography of cerebral arteries) [6].
The indications for selecting patients suitable for mechanical thrombectomy are associated with changes in imaging studies (computed tomography /CT/ and/or CT-angiography or magnetic resonance imaging /MRI/ of the head and/or MR angiography of cerebral arteries) [6]. If non-invasive arterial imaging cannot be performed, the patient has NIHSS > 9 points within the
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The magnetic resonance images (MRI) of the patient’s brain are compared with those of a clinically healthy person of the same age.
Clinical, neuropsychological and neuroimaging studies are conducted in parallel in 23-year old patient with proven dysgenesis of the corpus callosum. The magnetic resonance images (MRI) of the patient’s brain are compared with those of a clinically healthy person of the same age. To emphasize the typical morphologic features of the anomaly diffusion tensor imaging (DTI) and tractography were also held.
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With MRI of the brain we visualize the typical for DCC changes – lack of part of the truncus and the whole splenium, parallel direction of the lateral ventricles
The 23-old patient is with anamnesis of a febrile seizure experienced in the early childhood and followed by antiepileptic medical treatment for several years. Because of his delayed neuropsychological development and severe memory deficiency, he hardly finished his secondary education. According to his father he suffers from occasional headache and has a poor vocabulary background. The clinical assessment shows left facial hypotrophy and no other abnormalities. The neurological status reveals apraxia of upper limbs and the neuropsychological study – mild cognitive deficiency. With MRI of the brain we visualize the typical for DCC changes – lack of part of the truncus and the whole splenium, parallel direction of the lateral ventricles
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MRI tractography displays impaired fiber connectivity between the two hemispheres and heterotopic tracts not present in the healthy control.
This clinical case underlines the importance of neuroimaging modalities for the accurate diagnosis of brain anomalies. Magnetic resonance imaging, along with clinical and neuropsychological studies, can assess the degree of brain tissue reorganization in callosal dysgenesis. MRI tractography displays impaired fiber connectivity between the two hemispheres and heterotopic tracts not present in the healthy control. The existence of such anomalous connections are related to impaired neurocognitive and behavioural development of individuals with DCC.
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Brain MRI (T2WI) in patient with DCC
Brain MRI (T2WI) in patient with DCC
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With MRI of the brain we visualize the typical for dysgenesis of the corpus callosum changes – lack of the dorsal part of the truncus and the whole splenium of the corpus callosum (fig. 1A).
With MRI of the brain we visualize the typical for dysgenesis of the corpus callosum changes – lack of the dorsal part of the truncus and the whole splenium of the corpus callosum (fig. 1A). The dorsal cingulum is not formed. The sulci on the medial surface of the dorsal frontal and parietal lobe are radially oriented. There is a dorsal communication between the third ventricle and the interhemispheric fissure. The frontal horns and the atriums of the lateral ventricles are parallelly oriented on both sides and form the typical for this anomaly alterations – “racing car sign” on an axial view and “steer-horn sign” on a coronary view (fig. 1B, C).
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CT, MRI,
CT, MRI,
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For the final diagnosis prospective clinical and neuroimaging investigations (2D/3D/4D multimodal neurosonology, CT and MRI of the head) were performed.
The present report describes a 35-year-old man with a history of intermittent pain in the left retrobulbar area lasting approximately six months. The disease debuted with a general infectious syndrome, left-sided exophthalmos with transient visual disturbances and local inflammation of the conjunctiva. The condition was considered initially as conjunctivitis, and later – as Tolosa-Hunt syndrome, which was successfully treated with eye drops, nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics and corticosteroids. For the final diagnosis prospective clinical and neuroimaging investigations (2D/3D/4D multimodal neurosonology, CT and MRI of the head) were performed.
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Paralysis of one or more of the cranial nerves – oculomotor (III), trochlear (IV) and abducens (VI), and/or finding of granulomas by MRI or biopsy.
Paralysis of one or more of the cranial nerves – oculomotor (III), trochlear (IV) and abducens (VI), and/or finding of granulomas by MRI or biopsy.
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The wide differential diagnosis of Tolosa-Hunt syndrome requires taking an accurate history, conducting prospective clinical, paraclinical and neuroimaging studies (CT and/or MRI).
The wide differential diagnosis of Tolosa-Hunt syndrome requires taking an accurate history, conducting prospective clinical, paraclinical and neuroimaging studies (CT and/or MRI). Recently the neuro-ophthalmo-sonology has been applied as a fast and highly informative method for imaging normal and pathological eye structures aiding to distinguish the ophthalmological from the neuro-ophthalmological symptoms and syndromes [1, 2, 10].
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It was made a CT brain and orbits scan with contrast and MRI of the head with MR – angiography.
retrobulbar area lasting approximately six months. The disease debuted with a general infectious syndrome, left-sided exophthalmos with transient visual disturbances and local inflammation of the conjunctiva [12]. The patient was hospitalized in the Clinic of Ophthalmology and diagnosed with acute inflammation of the orbit. There were performed parallel clinical, paraclinical and ophthalmic research. Afterward he was examined three times by performing control and neuroimaging studies. It was made a CT brain and orbits scan with contrast and MRI of the head with MR – angiography. Multimodal neuroophthalmo-sonography with 2D/3D/4D imaging of the vitreous body, optic disc was performed, standard measurement of the complex optic nerve/sheath diameters and their ratio in 3 mm behind the globe, retrobulbar space and B-flow imaging of the ophthalmic and central retinal artery [2]. The patient was treated successfully with eye drops, nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics and corticosteroids.
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The control MRI
The control MRI
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The combined use of clinical, para-clinical and neuroimaging methods (CT with contrast, MRI with MR – angiography) enables the diagnosis and monitoring the disease.
the blood sugar and thyroid hormones [3, 7, 8, 9]. The combined use of clinical, para-clinical and neuroimaging methods (CT with contrast, MRI with MR – angiography) enables the diagnosis and monitoring the disease. Multimodal neurosonology helps to assess the optic bulb, optical disk and optic nerve, however, they have limited possibilities in the study of retrobulbar processes.
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Stenosis is asymptomatic if the diffusion-weighted magnetic resonance imaging (DW-MRI) do not reveal acute or subacute clinically (silent) ischemia [1].
Narrowing of the common carotid artery (CCA) or the internal carotid artery (ICA) due to atherosclerosis represents carotid artery stenosis. Stenosis is asymptomatic if the diffusion-weighted magnetic resonance imaging (DW-MRI) do not reveal acute or subacute clinically (silent) ischemia [1]. ACAS affects approximately 7% of women and more than 12% of men older than 70 years [2]. ACAS carries a risk for stroke that is less than 1% per year with less than 50% stenosis and 1% to 5% per year with greater than 50% stenosis [3]. About 34% of all strokes occur due to ICA thromboembolism. However, about two-thirds of patients with ICA thromboembolism will not have an ICA stenosis >50%, leaving rests being due to thromboembolism from a high grade (50-99%) previously asymptomatic ICA stenosis.
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Histological analyses of carotid plaques and magnetic resonance imaging (MRI) studies have shown that the finding of a lipid-rich, centrally necrotic plaque, a thin or ruptured fibrotic cap, or plaque hemorrhages is associated with an elevated cerebrovascular risk [8].
Histological analyses of carotid plaques and magnetic resonance imaging (MRI) studies have shown that the finding of a lipid-rich, centrally necrotic plaque, a thin or ruptured fibrotic cap, or plaque hemorrhages is associated with an elevated cerebrovascular risk [8].
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22. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 12, 2016, No. 2 , , ,

After 1990, with the improvement of neuroimaging methods (CAТ, MRI), HIFU usage as a therapeutic method in neurology has been on the increase.
After 1990, with the improvement of neuroimaging methods (CAТ, MRI), HIFU usage as a therapeutic method in neurology has been on the increase. Precise focusing of the ultrasound in the target zone became possible by coupling the focused ultrasound with magnetic resonance imaging (Magnetic-resonance guided Focused ultrasound surgery, MRgFUS), used for the first time in neurosurgery. Magnetic resonance allows also for precise real-time termography [8, 9, 23]. In 2004 US Food and Drug Administration approved MRgFUS for treatment of uterine fibroids, in 2012
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With MRI navigation in intracranial application/C МРТ навигация при интракраниално приложение
With MRI navigation in intracranial application/C МРТ навигация при интракраниално приложение
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The eхact localization of the target structures is realized through MRI navigation and HIFU with sub-ablation temperature up to 45°С, monitored by means of magnetic resonance thermography.
1 with akinetic form with on-dyskinesias and 3 with akinetic-tremulous form with on-dyskinesias). The used apparatus is ЕхАblate Neuro with a 1024-element panel, operating with 0.71 MHz. The eхact localization of the target structures is realized through MRI navigation and HIFU with sub-ablation temperature up to 45°С, monitored by means of magnetic resonance thermography. Pallidotractotomy is performed through gradual temperature and power increase of HIFU (up to 1200 W for 13 s at 52–59°С) and is confirmed by MRI after the procedure. The patients were conscious throughout the intervention, but medicated with lorazepam sublingually and gastro-protectors. In 4 patients, affected by a single dose of HIFU, a transitional clinical improvement was observed immediately after pallidotractotomy, which diminished in three months of tracking. In the remaining 9 patients, the procedure was repeated 4–5 times and the improvement was long-term and comparable to radiofrequency pallidotractotomy. Significant side effects of the procedure were not reported.
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Pallidotractotomy is performed through gradual temperature and power increase of HIFU (up to 1200 W for 13 s at 52–59°С) and is confirmed by MRI after the procedure.
1 with akinetic form with on-dyskinesias and 3 with akinetic-tremulous form with on-dyskinesias). The used apparatus is ЕхАblate Neuro with a 1024-element panel, operating with 0.71 MHz. The eхact localization of the target structures is realized through MRI navigation and HIFU with sub-ablation temperature up to 45°С, monitored by means of magnetic resonance thermography. Pallidotractotomy is performed through gradual temperature and power increase of HIFU (up to 1200 W for 13 s at 52–59°С) and is confirmed by MRI after the procedure. The patients were conscious throughout the intervention, but medicated with lorazepam sublingually and gastro-protectors. In 4 patients, affected by a single dose of HIFU, a transitional clinical improvement was observed immediately after pallidotractotomy, which diminished in three months of tracking. In the remaining 9 patients, the procedure was repeated 4–5 times and the improvement was long-term and comparable to radiofrequency pallidotractotomy. Significant side effects of the procedure were not reported.
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Despite being confirmed by MRI, this method has not found application in humans.
Еxperiments on animal models show that HIFU with frequency of 1.2 MHz can cause thermal ablation of n. ischiadicus [20]. Despite being confirmed by MRI, this method has not found application in humans.
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FDA approves first MRI-guided focused ultrasound device to treat essential tremor.
FDA News Release. FDA approves first MRI-guided focused ultrasound device to treat essential tremor.
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Non-Invasive Targeted Peripheral Nerve Ablation Using 3D MR Neurography and MRI-Guided High-Intensity Focused Ultrasound (MR-HIFU): Pilot Study in a Swine Model.
Huisman M, Staruch RM, Ladouceur-Wodzak M, Van Den Bosch MA, Burns DK, Chhabra A, Chopra R. Non-Invasive Targeted Peripheral Nerve Ablation Using 3D MR Neurography and MRI-Guided High-Intensity Focused Ultrasound (MR-HIFU): Pilot Study in a Swine Model.
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Noninvasive arterial occlusion using MRI-guided focused ultrasound.
Hynynen K, Colucci V, Chung A, Jolesz F. Noninvasive arterial occlusion using MRI-guided focused ultrasound.
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MRI-guided targeted blood-brain barrier disruption with focused ultrasound: Histological findings in rabbits.
McDannold N, Vykhodtseva N, Raymond S, Jolesz FA, Hynynen K. MRI-guided targeted blood-brain barrier disruption with focused ultrasound: Histological findings in rabbits.
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Non-invasive delivery of stealth, brainpenetrating nanoparticles across the blood Brain barrier using MRI-guided focused ultrasound.
Nance E, Timbie K, Miller GW, Song J, Louttit C, Klibanov AL, Shih TY, Swaminathan G, Tamargo RJ, Woodworth GF, Hanes J, Price RJ. Non-invasive delivery of stealth, brainpenetrating nanoparticles across the blood Brain barrier using MRI-guided focused ultrasound.
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MRI guided focused ultrasound thalamotomy for moderate-to-severe tremor in Parkinson’s disease.
Schlesinger I, Eran A, Sinai A, Erikh I, Nassar M, Goldsher D, Zaaroor M. MRI guided focused ultrasound thalamotomy for moderate-to-severe tremor in Parkinson’s disease.
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Orbital MRI revealed dilated superior ophthalmic veins with thrombosis bilaterally.
We present a patient with bilateral superior ophthalmic vein thrombosis diagnosed with orbital MR examination. The patient had bubbling right-facial-pain and visual deterioration. Orbital MRI revealed dilated superior ophthalmic veins with thrombosis bilaterally. Ten days after treatment initiation, the patient left the hospital; completely pain free, with normal visual acuity and full motility of ocular bulbs.
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MRI finding with bilateral SOVT – axial
MRI finding with bilateral SOVT – axial
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P8 Accuracy of Sudancupping Test for the Diagnosis of Cervical and Lumbsacral Disc Prolapse to Instrumental Investigations (Xray, CT and MRI).
P8 Accuracy of Sudancupping Test for the Diagnosis of Cervical and Lumbsacral Disc Prolapse to Instrumental Investigations (Xray, CT and MRI).
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(1) pre-bioprinting: includes biopsy of the desired organ or tissue, depiction by computer (CT) or magnetic resonance imaging (MRI), creation of a virtual model, selection of the cell culture, broths and selection of technology; (2) bioprinting: setting a mixture of selected cells, broths and bioink in a special printer (Inkjet, Microextrusion or Laser-assisted), incubation and conversion of the mixture into a tissue with a subsequent nano-dimensional multi-layer printing of the target CT/MRI image; (3) post-bioprinting: biological stabilization of the resulting organ or tissue.
(1) pre-bioprinting: includes biopsy of the desired organ or tissue, depiction by computer (CT) or magnetic resonance imaging (MRI), creation of a virtual model, selection of the cell culture, broths and selection of technology; (2) bioprinting: setting a mixture of selected cells, broths and bioink in a special printer (Inkjet, Microextrusion or Laser-assisted), incubation and conversion of the mixture into a tissue with a subsequent nano-dimensional multi-layer printing of the target CT/MRI image; (3) post-bioprinting: biological stabilization of the resulting organ or tissue. The creation of biomaterials is achieved through different approaches: biomimicry (cultivation of identical microcellular and extracellular structures), autonomous self-assembly (through embryonic embedded replication of the corresponding
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An ischemic stroke in the left part of medulla oblongata and the left part of cerebellum were seen on MRI.
Angiographic examination revealed a dissection of the left vertebral artery and the proximal part of the basilar artery. An ischemic stroke in the left part of medulla oblongata and the left part of cerebellum were seen on MRI.
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According to our study, MRI and MRA of the vertebral arteries in an young patient without risk factors for cerebrovascular disease, with acute neurologic symptoms can be used as an accurate diagnosis and treatment.
Dissection is one of the major causes for ischaemic stroke in young adults. Early identification and management of spontaneous dissection is important. According to our study, MRI and MRA of the vertebral arteries in an young patient without risk factors for cerebrovascular disease, with acute neurologic symptoms can be used as an accurate diagnosis and treatment.
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At the Clinic the patient presents with clinical evidence of ischemic stroke in the right middle cerebral artery, MRI shows evidence of multiple, possibly thromboembolic acute vascular events in the right middle cerebral artery area, and echocardiography: a patent foramen ovale, and right-toleft shunt, category 4.
At the Clinic the patient presents with clinical evidence of ischemic stroke in the right middle cerebral artery, MRI shows evidence of multiple, possibly thromboembolic acute vascular events in the right middle cerebral artery area, and echocardiography: a patent foramen ovale, and right-toleft shunt, category 4. During the hospital stay a recovery of the motor deficit with a residual left-sided latent hemiparesis is seen.
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ACCURACY OF SUDANCUPPING TEST FOR THE DIAGNOSIS OF CERVICAL AND LUMBSACRAL DISC PROLAPSE TO INSTRUMENTAL INVESTIGATIONS (XRAY, CT AND MRI)
ACCURACY OF SUDANCUPPING TEST FOR THE DIAGNOSIS OF CERVICAL AND LUMBSACRAL DISC PROLAPSE TO INSTRUMENTAL INVESTIGATIONS (XRAY, CT AND MRI)
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Diagnosis of lumbosacral disk prolapse is based on the clinical examination, but must be confirmed by radiological tests such as X-ray, computed tomography (CT) and magnetic resonance imaging (MRI).
Diagnosis of lumbosacral disk prolapse is based on the clinical examination, but must be confirmed by radiological tests such as X-ray, computed tomography (CT) and magnetic resonance imaging (MRI). These tests are usually expensive and not available everywhere. This study shows the use of a dry cupping technique for diagnostic purposes for the first time in the world. It is a newly registered test called Sudan-cupping test. We apply the cups in certain areas over the human body (neck, back), and detect their effect over the patients complains (neck and lower back pain, sciatica, numbness, etc.). The test is positive if complains decrease or disappear when we apply the cups in that area.
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We then send the cupping-positive patients for instrumental examinations, mainly MRI.
These tests are usually expensive and not available everywhere. This study shows the use of a dry cupping technique for diagnostic purposes for the first time in the world. It is a newly registered test called Sudan-cupping test. We apply the cups in certain areas over the human body (neck, back), and detect their effect over the patients complains (neck and lower back pain, sciatica, numbness, etc.). The test is positive if complains decrease or disappear when we apply the cups in that area. We then send the cupping-positive patients for instrumental examinations, mainly MRI. On MRI we detect the accuracy of this test for the diagnosis of cervical and lumbosacral disc prolapse.
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On MRI we detect the accuracy of this test for the diagnosis of cervical and lumbosacral disc prolapse.
This study shows the use of a dry cupping technique for diagnostic purposes for the first time in the world. It is a newly registered test called Sudan-cupping test. We apply the cups in certain areas over the human body (neck, back), and detect their effect over the patients complains (neck and lower back pain, sciatica, numbness, etc.). The test is positive if complains decrease or disappear when we apply the cups in that area. We then send the cupping-positive patients for instrumental examinations, mainly MRI. On MRI we detect the accuracy of this test for the diagnosis of cervical and lumbosacral disc prolapse.
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The study showed that 93.5% of the tested patients with positive cupping test had positive MRI reports (presenting a prolapsed disk), 4.9% of patients had negative cupping test and positive MRI reports, and 1.6% of patients had positive cupping test and negative MRI reports.
The study showed that 93.5% of the tested patients with positive cupping test had positive MRI reports (presenting a prolapsed disk), 4.9% of patients had negative cupping test and positive MRI reports, and 1.6% of patients had positive cupping test and negative MRI reports.
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The test is sensitive and applicable in areas where the use of MRI, CT or even X-ray is not available, and in poor areas where patients cannot afford to do expensive investigations.
Cupping test is accurate, cheap, simple and easy for application. The test is sensitive and applicable in areas where the use of MRI, CT or even X-ray is not available, and in poor areas where patients cannot afford to do expensive investigations.
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23. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 13, 2017, No. 1 , , ,

Several studies have reported significant correlation (r=0,64) between TCCD and MRI findings in the
In contrast, findings from different studies showed that the presence of leptomeningeal collateral flow was associated with an increased risk of future ischemic stroke [1, 4–6]. The actual contribution of the individual collateral pathways is difficult to assess and quantify. Assessment of cerebral hemodynamics can be performed with different techniques. The non-invasive evaluation of the collateral circulation status became possible only after introduction into clinical practice of several neuro-angioimaging tools, as Computed Tomography angiography (CTA), Magnetic-resonance angiography ((MRA), Color Doppler sonography (CDUS), Transcranial Color Doppler (TCCD) modalities. All above-mentioned modalities give valuable information about the presence and efficiency of collateral supply in patients with ICA occlusive changes. Several studies have reported significant correlation (r=0,64) between TCCD and MRI findings in the
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The technological process consists of three stages: (1) pre-bioprinting includes biopsy of the desired organ or tissue, depiction by computer (CT) or magnetic resonance imaging (MRI), creation of a virtual model, selection of cell culture, broths and technology; (2) bioprinting – setting a mixture of selected cells, broths and bioink in a special printer (Inkjet, Microextrusion or Laserassisted), incubation and conversion of the mixture into a tissue with a subsequent nano-dimensional multi-layer printing of the target CT/MRI image; (3) post-bioprinting
Three-dimensional bioprinting is a new method for identical reproduction of biological tissues and organs by layering living cells. The technological process consists of three stages: (1) pre-bioprinting includes biopsy of the desired organ or tissue, depiction by computer (CT) or magnetic resonance imaging (MRI), creation of a virtual model, selection of cell culture, broths and technology; (2) bioprinting – setting a mixture of selected cells, broths and bioink in a special printer (Inkjet, Microextrusion or Laserassisted), incubation and conversion of the mixture into a tissue with a subsequent nano-dimensional multi-layer printing of the target CT/MRI image; (3) post-bioprinting
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It starts with imaging the target structure by computer (CT) or magnetic resonance imaging (MRI), creation of a virtual model, selection of the cell culture, broths and technology.
includes a biopsy of the desired organ or tissue. It starts with imaging the target structure by computer (CT) or magnetic resonance imaging (MRI), creation of a virtual model, selection of the cell culture, broths and technology. At this stage, the main used approach is biomimicry for cultivation of identical microcellular and extracellular structures [15, 19, 22, 32].
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Incubation and conversion of the mixture into a tissue with a subsequent nano-dimensional multi-layer printing of the target CT/MRI image are performed [4, 8, 32].
In a speciаl bioprinter (Inkjet, Microextruction or Laserassisted), a suitable broth, mixture of selected cells and bioink are placed. Incubation and conversion of the mixture into a tissue with a subsequent nano-dimensional multi-layer printing of the target CT/MRI image are performed [4, 8, 32].
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X-ray Biomimicry Synthetic polymers Differentiated cells Inkjet Maturation CT Self-assembly Natural polymers Pluripotent stem cells Microextrusion Implantation MRI Mini-tissues Extracellular matrix Multipotent stem cells Laser-assisted In vivo testing
X-ray Biomimicry Synthetic polymers Differentiated cells Inkjet Maturation CT Self-assembly Natural polymers Pluripotent stem cells Microextrusion Implantation MRI Mini-tissues Extracellular matrix Multipotent stem cells Laser-assisted In vivo testing
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24. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 13, 2017, No. 2 , , ,

Cardiovascular Health Study [27] evaluated 3660 subjects aged over 65 who underwent an MRI scan to associate fish consumption and risk of subclinical brain abnormalities on MRI in older adults.
Fish consumption may be inversely associated with ischemic stroke but not with hemorrhagic stroke, because of the potential antiplatelet aggregation property of LCn3PUFAs. A meta-analysis of 8 independent prospective cohort studies which included 200575 subjects and 3491 stroke events showed that individuals with higher fish intake had lower risk of total stroke, compared with those who never consumed fish or ate fish less than once per month. The reduction in risk of total stroke was statistically significant for fish intake once per week; for individuals who ate fish 5 times or more per week, the risk of stroke was lowered by 31%. The risk of ischemic stroke was also significantly reduced by eating fish twice per month. It has been suggested that broiled and baked fish, but not fried fish and fish sandwiches, are associated with a lower incidence of atrial fibrillation (AF) and ischemic heart disease. Cardiovascular Health Study [27] evaluated 3660 subjects aged over 65 who underwent an MRI scan to associate fish consumption and risk of subclinical brain abnormalities on MRI in older adults. Among older adults, modest consumption of tuna/other fish, but not fried fish, was associated with lower prevalence of subclinical infarcts and white matter abnormalities on MRI examinations. Tuna or other fish consumption was also associated
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Among older adults, modest consumption of tuna/other fish, but not fried fish, was associated with lower prevalence of subclinical infarcts and white matter abnormalities on MRI examinations.
A meta-analysis of 8 independent prospective cohort studies which included 200575 subjects and 3491 stroke events showed that individuals with higher fish intake had lower risk of total stroke, compared with those who never consumed fish or ate fish less than once per month. The reduction in risk of total stroke was statistically significant for fish intake once per week; for individuals who ate fish 5 times or more per week, the risk of stroke was lowered by 31%. The risk of ischemic stroke was also significantly reduced by eating fish twice per month. It has been suggested that broiled and baked fish, but not fried fish and fish sandwiches, are associated with a lower incidence of atrial fibrillation (AF) and ischemic heart disease. Cardiovascular Health Study [27] evaluated 3660 subjects aged over 65 who underwent an MRI scan to associate fish consumption and risk of subclinical brain abnormalities on MRI in older adults. Among older adults, modest consumption of tuna/other fish, but not fried fish, was associated with lower prevalence of subclinical infarcts and white matter abnormalities on MRI examinations. Tuna or other fish consumption was also associated
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Greater gray matter volume, measured by MRI was found with higher aerobic activity, pointing out that it might be neuroprotective.
Epidemiological and prospective studies have shown that physical activity enhances cognitive and brain function and protects against development of neurodegenerative diseases. Extensive research is going on to prove biological mechanisms that underlie such beneficial effect. Multidomain interventions could improve or maintain cognitive function in at-risk elederly people (FINGER study 2015). Prevention is the key. Greater gray matter volume, measured by MRI was found with higher aerobic activity, pointing out that it might be neuroprotective.
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Fish consumption and risk of subclinical brain abnormalities on MRI in older adults.
Virtanen JK, Siscovick DS, Longstreth WT Jr., Kuller LH, Mozaffarian D. Fish consumption and risk of subclinical brain abnormalities on MRI in older adults.
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The DAWN study sought to answer whether advanced imaging methods with MRI DWI and CT-perfusion can be used to successfully select patients for endovascular therapy, even though they present late or have an uncertain onset of symptoms.
The DAWN study sought to answer whether advanced imaging methods with MRI DWI and CT-perfusion can be used to successfully select patients for endovascular therapy, even though they present late or have an uncertain onset of symptoms. They included patients in whom brain imaging demonstrated a significant area of potentially salvageable brain tissue. Endovascular treatment significantly reduced disability compared to medically managed patients.:
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Those discussions are reinforced by recent findings of MRI in patients with ICH.
Another important difference between INTERACT and ATACH is that in ATACH II, although the blood pressure targets were defined similarly as in INTERACT, the actual achieved levels in the control group were similar to the intensive management arm in INTERACT, whereas the intensive arm in ATACH was at mean levels of 120 mmHg systolic blood pressure. This comparison between “intensive” (as achieved in INTERACT) and “very intensive” blood pressure lowering did not result in a statistically significant difference in clinical outcome, even a trend was not observed. There were, however, significantly more severe adverse events in the treatment arm. After ATACH II was published in 2016, most experts did not see a necessity to change the current recommendations for the clinical routine again based on this trial. ATACH, however, opened more space for discussion on blood pressure lowering in ICH, especially with respect to possible harms beyond a “sweet spot” of a safe target value. Those discussions are reinforced by recent findings of MRI in patients with ICH. A retrospective study by Prabhakaran and colleagues [44] described distant small ischemic lesions (areas of restricted diffusion on DWI imaging) and found a correlation between those lesions, extensive blood pressure reduction, and worse clinical outcome. Those findings were recently confirmed in a larger prospective cohort from the ERICH study [25], demonstrating that roughly a quarter of all spontaneous ICH patients show such lesions on MRI. Summarizing those trials, 140 mmHg seems to remain a safe target for blood pressure management in acute ICH and avoiding strong variability of blood pressure seems also to be very important in such patients. Future studies should include MRI imaging in order to estimate the role of DWI lesions and their association with blood pressure lowering.
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Those findings were recently confirmed in a larger prospective cohort from the ERICH study [25], demonstrating that roughly a quarter of all spontaneous ICH patients show such lesions on MRI.
There were, however, significantly more severe adverse events in the treatment arm. After ATACH II was published in 2016, most experts did not see a necessity to change the current recommendations for the clinical routine again based on this trial. ATACH, however, opened more space for discussion on blood pressure lowering in ICH, especially with respect to possible harms beyond a “sweet spot” of a safe target value. Those discussions are reinforced by recent findings of MRI in patients with ICH. A retrospective study by Prabhakaran and colleagues [44] described distant small ischemic lesions (areas of restricted diffusion on DWI imaging) and found a correlation between those lesions, extensive blood pressure reduction, and worse clinical outcome. Those findings were recently confirmed in a larger prospective cohort from the ERICH study [25], demonstrating that roughly a quarter of all spontaneous ICH patients show such lesions on MRI. Summarizing those trials, 140 mmHg seems to remain a safe target for blood pressure management in acute ICH and avoiding strong variability of blood pressure seems also to be very important in such patients. Future studies should include MRI imaging in order to estimate the role of DWI lesions and their association with blood pressure lowering.
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Future studies should include MRI imaging in order to estimate the role of DWI lesions and their association with blood pressure lowering.
ATACH, however, opened more space for discussion on blood pressure lowering in ICH, especially with respect to possible harms beyond a “sweet spot” of a safe target value. Those discussions are reinforced by recent findings of MRI in patients with ICH. A retrospective study by Prabhakaran and colleagues [44] described distant small ischemic lesions (areas of restricted diffusion on DWI imaging) and found a correlation between those lesions, extensive blood pressure reduction, and worse clinical outcome. Those findings were recently confirmed in a larger prospective cohort from the ERICH study [25], demonstrating that roughly a quarter of all spontaneous ICH patients show such lesions on MRI. Summarizing those trials, 140 mmHg seems to remain a safe target for blood pressure management in acute ICH and avoiding strong variability of blood pressure seems also to be very important in such patients. Future studies should include MRI imaging in order to estimate the role of DWI lesions and their association with blood pressure lowering.
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With contemporary high-end ultrasound systems, image resolution of echogenic deep brain structures can even be higher on TCS than on magnetic resonance imaging (MRI).
Transcranial B-mode sonography (TCS) is a non-invasive, low-cost, short-duration neuroimaging method that allows high-resolution imaging of deep brain structures in patients with movement disorders. With contemporary high-end ultrasound systems, image resolution of echogenic deep brain structures can even be higher on TCS than on magnetic resonance imaging (MRI). Hyperechogenicity of the substantia nigra (SN), a TCS finding seen in about 90% of patients with idiopathic Parkinson's disease (PD), is already present in presymptomatic disease stages and indicates an increased risk of developing PD, especially if present in combination with other risk markers. The TCS finding of SN hyperechogenicity well discriminates PD from other Parkinsonian disorders such as multiple-system atrophy and welding-related Parkinsonism. In turn, normal SN echogenicity in combination with lenticular nucleus hyperechogenicity indicates an atypical Parkinsonian syndrome rather than PD with a specificity of more than 95%. TCS detects characteristic basal ganglia changes also in other movement disorders such as lenticular nucleus hyperechogenicity in idiopathic dystonia and Wilson's disease and caudate nucleus hyperechogenicity in Huntington's disease. Reduced echogenicity of midbrain raphe is frequent in depressive disorders and correlated with both suicidal ideation and responsiveness to serotonin reuptake inhibitors.
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Upcoming technologies such as digitized image analysis and TCS-MRI fusion imaging will promote novel diagnostic applications of TCS in neurodegenerative brain disorders.
The TCS finding of SN hyperechogenicity well discriminates PD from other Parkinsonian disorders such as multiple-system atrophy and welding-related Parkinsonism. In turn, normal SN echogenicity in combination with lenticular nucleus hyperechogenicity indicates an atypical Parkinsonian syndrome rather than PD with a specificity of more than 95%. TCS detects characteristic basal ganglia changes also in other movement disorders such as lenticular nucleus hyperechogenicity in idiopathic dystonia and Wilson's disease and caudate nucleus hyperechogenicity in Huntington's disease. Reduced echogenicity of midbrain raphe is frequent in depressive disorders and correlated with both suicidal ideation and responsiveness to serotonin reuptake inhibitors. TCS reliably and safely displays deep brain stimulation electrodes in patients with movement disorders and allows intraand postoperative monitoring of electrode location. Upcoming technologies such as digitized image analysis and TCS-MRI fusion imaging will promote novel diagnostic applications of TCS in neurodegenerative brain disorders.
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Upcoming technologies such as digitized image analysis and TCS-MRI fusion imaging promote novel diagnostic applications of TCS [7, 14].
ventricle, frontal horns of lateral ventricles and if needed the cella media. Upcoming technologies such as digitized image analysis and TCS-MRI fusion imaging promote novel diagnostic applications of TCS [7, 14].
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Contemporary ultrasound systems allow high-resolution transcranial imaging of small echogenic deep intracranial structures similarly as MRI: a phantom study.
Walter U, Kanowski M, Kaufmann J, et al. Contemporary ultrasound systems allow high-resolution transcranial imaging of small echogenic deep intracranial structures similarly as MRI: a phantom study.
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In these cases US may be useful but it cannot replace magnetic resonance imaging (MRI) that is crucial for assessing the roots avulsions that frequently occur in brachial plexus injury [8].
In TNL US contribution was particularly crucial (83.8% of the cases) in presence of complete axonal damage demonstrating the discontinuity of the nerve (neurotmesis) or continuity (axonotmesis). Moreover, in case of neurotmesis US was useful also to assess the distance between the nerve ends, presurgically providing data on the need of nerve graft and excluding neuromas or frayed nerve endings that surgically must be excluded. Concerning brachial plexus injury, that in our sample represented 16% of cases, it must be noted that US can provide only partial information because of blind tracts due to the clavicle, on the tract out of the spine. In these cases US may be useful but it cannot replace magnetic resonance imaging (MRI) that is crucial for assessing the roots avulsions that frequently occur in brachial plexus injury [8].
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Although good reliability of ultrasound muscle imaging has been proved by CT and MRI [15], its clinical application in neurology is still restricted mainly to particular research or treatment protocols.
Although good reliability of ultrasound muscle imaging has been proved by CT and MRI [15], its clinical application in neurology is still restricted mainly to particular research or treatment protocols.
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The upcoming MRI-ultrasound fusion imaging techniques that are available already today with advanced ultrasound systems allow the ultrasound-guided targeting also of small deep muscles such as the longus colli muscle in patients with antecollis.
Visual identification of muscles and depth control of needle placement are the key features of ultrasoundguided injection that lead to improved targeting and safety of BoNT injections. Ultrasound may be helpful to validate already established injection techniques or when learning the correct injection technique. Ultrasound-guided BoNT injection has been recommended as a standard procedure in treatment of lower leg spasticity in children with cerebral palsy. In recent years, this technique has been increasingly used also for the exact targeting of BoNT injection in patients with cervical dystonia. The ultrasoundguided BoNT injection is especially recommendable if the scalene muscles; the longus colli, longisslimus capitis, or the obliquus capitis inferior muscles are targeted. The upcoming MRI-ultrasound fusion imaging techniques that are available already today with advanced ultrasound systems allow the ultrasound-guided targeting also of small deep muscles such as the longus colli muscle in patients with antecollis.
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An interesting novel approach for selected patients is ultrasound-MRI real-time fusion imaging to target BoNT injection into very deep muscles [7].
8]. The exact knowledge of the muscular anatomy including its display on ultrasound and training of eye-hand coordination are prerequisites for the US-guided approach. If US-guided BoNT injection is adequately performed the results are a stable therapeutic response and often the need of lower BoNT doses compared to the visual approach of BT injection. An interesting novel approach for selected patients is ultrasound-MRI real-time fusion imaging to target BoNT injection into very deep muscles [7].
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25. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 14, 2018, No. 1 , , ,

Structural MRI data showing decreased volume of pars opercularis in children with autism
Structural MRI data showing decreased volume of pars opercularis in children with autism
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The Mirror Neurons Network in Aging, Mild Cognitive Impairment, and Alzheimer Disease: A functional MRI Study.
Farina E, Baglio F, Pomati S. The Mirror Neurons Network in Aging, Mild Cognitive Impairment, and Alzheimer Disease: A functional MRI Study.
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Iatrogenic vertebral artery pseudoaneurysm: US, CT and MRI findings.
Cihangiroglu M, Rahman A, Yildirim H, Burma O, Uysal H. Iatrogenic vertebral artery pseudoaneurysm: US, CT and MRI findings.
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We conducted magnetic resonance imaging (MRI) and TCS in 5 unrelated patients with pantothenate kinase-associated neurodegeneration (PKAN), caused by PANK2 mutations.
Similar findings were observed in some other neurodegenerative diseases with trace metals accumulation. We conducted magnetic resonance imaging (MRI) and TCS in 5 unrelated patients with pantothenate kinase-associated neurodegeneration (PKAN), caused by PANK2 mutations. All patients had an eye of the tiger sign. Hypointense lesions on the T2-weighted MRI images were restricted to the globus pallidus (GP) and SN. TCS also revealed bilateral hyperechogenicity restricted to the LN and SN, with normal values of the third ventricle diameter. Both TCS and MRI studies in PKAN patients are in accordance with the pathological findings that accumulation of iron, even in advanced cases, is restricted to the GP and SN, suggesting selective involvement of these structures [11].
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Hypointense lesions on the T2-weighted MRI images were restricted to the globus pallidus (GP) and SN.
Similar findings were observed in some other neurodegenerative diseases with trace metals accumulation. We conducted magnetic resonance imaging (MRI) and TCS in 5 unrelated patients with pantothenate kinase-associated neurodegeneration (PKAN), caused by PANK2 mutations. All patients had an eye of the tiger sign. Hypointense lesions on the T2-weighted MRI images were restricted to the globus pallidus (GP) and SN. TCS also revealed bilateral hyperechogenicity restricted to the LN and SN, with normal values of the third ventricle diameter. Both TCS and MRI studies in PKAN patients are in accordance with the pathological findings that accumulation of iron, even in advanced cases, is restricted to the GP and SN, suggesting selective involvement of these structures [11].
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Both TCS and MRI studies in PKAN patients are in accordance with the pathological findings that accumulation of iron, even in advanced cases, is restricted to the GP and SN, suggesting selective involvement of these structures [11].
Similar findings were observed in some other neurodegenerative diseases with trace metals accumulation. We conducted magnetic resonance imaging (MRI) and TCS in 5 unrelated patients with pantothenate kinase-associated neurodegeneration (PKAN), caused by PANK2 mutations. All patients had an eye of the tiger sign. Hypointense lesions on the T2-weighted MRI images were restricted to the globus pallidus (GP) and SN. TCS also revealed bilateral hyperechogenicity restricted to the LN and SN, with normal values of the third ventricle diameter. Both TCS and MRI studies in PKAN patients are in accordance with the pathological findings that accumulation of iron, even in advanced cases, is restricted to the GP and SN, suggesting selective involvement of these structures [11].
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(e.g. tremulous or agitated) patients, the fact that it is quick and repeatedly performable with no limitations as known from other neuroimaging techniques (metal in the body as a limitation for MRI imaging, specific medication as a limitation for many forms of functional neuroimaging), and that it is relatively cheap and side effect free.
(e.g. tremulous or agitated) patients, the fact that it is quick and repeatedly performable with no limitations as known from other neuroimaging techniques (metal in the body as a limitation for MRI imaging, specific medication as a limitation for many forms of functional neuroimaging), and that it is relatively cheap and side effect free.
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Contemporary ultrasound systems allow highresolution transcranial imaging of small echogenic deep intracranial structures similarly as MRI: a phantom study.
Walter U, Kanowski M, Kaufmann J, Grossmann A, Benecke R, Niehaus L. Contemporary ultrasound systems allow highresolution transcranial imaging of small echogenic deep intracranial structures similarly as MRI: a phantom study.
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26. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 14, 2018, No. 2 , , ,

All patients underwent a complete diagnostic workup: cerebral CT/MRI at admission, extracranial colorcoded duplex sonography, transcranial colorcoded sonography (TCCS), CT angiography (CTA) or magnetic resonance angiography (MRA) if CTA was contraindicated, 24-hours cardiac monitoring, trans-thoracic echocardiography (TTE) completed by trans-esophageal echocardiography (TEE) if appropriate, and coagulation studies.
their demographics, clinical characteristics, routine blood tests, and vascular risk factors. All patients underwent a complete diagnostic workup: cerebral CT/MRI at admission, extracranial colorcoded duplex sonography, transcranial colorcoded sonography (TCCS), CT angiography (CTA) or magnetic resonance angiography (MRA) if CTA was contraindicated, 24-hours cardiac monitoring, trans-thoracic echocardiography (TTE) completed by trans-esophageal echocardiography (TEE) if appropriate, and coagulation studies. Diagnosis of right-to-left shunt (RLS) was made by contrastenhanced TCCS (cTCCS) performed at rest and after Valsalva maneuver, and the presence of a patent foramen ovale (PFO) was confirmed by a contrast TTE or TEE; RLS was graded according to the number of bubbles detected by cTCCS: low-grade (1-10 MES), medium-grade (>10 MES), high-grade (shower or curtain effect). During hospitalization, the vital parameters of all enrolled patients were continuously monitored for the first 72 hours in order to detect and treat any alteration in heart rate, heart rhythm, respiratory dynamics, oxyhemoglobin saturation, arterial blood pressure and body temperature. A 24-hours brain MRI/CT was performed along with a brain MRI just before hospital discharge. In case of a neurologic deterioration – an increase in National Institutes of Health Stroke Scale (NIHSS) score
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A 24-hours brain MRI/CT was performed along with a brain MRI just before hospital discharge.
their demographics, clinical characteristics, routine blood tests, and vascular risk factors. All patients underwent a complete diagnostic workup: cerebral CT/MRI at admission, extracranial colorcoded duplex sonography, transcranial colorcoded sonography (TCCS), CT angiography (CTA) or magnetic resonance angiography (MRA) if CTA was contraindicated, 24-hours cardiac monitoring, trans-thoracic echocardiography (TTE) completed by trans-esophageal echocardiography (TEE) if appropriate, and coagulation studies. Diagnosis of right-to-left shunt (RLS) was made by contrastenhanced TCCS (cTCCS) performed at rest and after Valsalva maneuver, and the presence of a patent foramen ovale (PFO) was confirmed by a contrast TTE or TEE; RLS was graded according to the number of bubbles detected by cTCCS: low-grade (1-10 MES), medium-grade (>10 MES), high-grade (shower or curtain effect). During hospitalization, the vital parameters of all enrolled patients were continuously monitored for the first 72 hours in order to detect and treat any alteration in heart rate, heart rhythm, respiratory dynamics, oxyhemoglobin saturation, arterial blood pressure and body temperature. A 24-hours brain MRI/CT was performed along with a brain MRI just before hospital discharge. In case of a neurologic deterioration – an increase in National Institutes of Health Stroke Scale (NIHSS) score
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>4 – immediate CT or MRI was obtained to check for ICH or recurrence.
>4 – immediate CT or MRI was obtained to check for ICH or recurrence. Having completed the diagnostic work-up, we excluded from the study those patients with large vessel disease, small vessel disease, cardioembolism, other specific causes (e.g. dissection, vasculitis, confirmed source for paradoxical embolism), and multiple causes (undetermined etiology). Furthermore, based on MRI/CT scan pattern, cryptogenic strokes were divided into two categories: ESUS and non-ESUS [10]. All patients were placed on anti-thrombotic treatment and modifiable risk factors (eg. hypertension, hypercholesterolemia, hyperglycemia, etc.) were corrected according to current guidelines [8].
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Furthermore, based on MRI/CT scan pattern, cryptogenic strokes were divided into two categories: ESUS and non-ESUS [10].
>4 – immediate CT or MRI was obtained to check for ICH or recurrence. Having completed the diagnostic work-up, we excluded from the study those patients with large vessel disease, small vessel disease, cardioembolism, other specific causes (e.g. dissection, vasculitis, confirmed source for paradoxical embolism), and multiple causes (undetermined etiology). Furthermore, based on MRI/CT scan pattern, cryptogenic strokes were divided into two categories: ESUS and non-ESUS [10]. All patients were placed on anti-thrombotic treatment and modifiable risk factors (eg. hypertension, hypercholesterolemia, hyperglycemia, etc.) were corrected according to current guidelines [8].
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In our case clinical picture and carotid Doppler ultrasound had an important role in diagnosis of the internal carotid artery dissection, despite inconclusive finding of CTA, which is according to recent studies better alternative to magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA) [8, 20].
In our case clinical picture and carotid Doppler ultrasound had an important role in diagnosis of the internal carotid artery dissection, despite inconclusive finding of CTA, which is according to recent studies better alternative to magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA) [8, 20]. Intraplaque hemorrhage of the carotid atherosclerosis is a potential differential diagnosis [11]. A limitiation of the case report was that we could not perform fat-supressed MRI which offers direct visualization of the mural hematoma [7]. MRA and CTA might
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A limitiation of the case report was that we could not perform fat-supressed MRI which offers direct visualization of the mural hematoma [7].
In our case clinical picture and carotid Doppler ultrasound had an important role in diagnosis of the internal carotid artery dissection, despite inconclusive finding of CTA, which is according to recent studies better alternative to magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA) [8, 20]. Intraplaque hemorrhage of the carotid atherosclerosis is a potential differential diagnosis [11]. A limitiation of the case report was that we could not perform fat-supressed MRI which offers direct visualization of the mural hematoma [7]. MRA and CTA might
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[mri with fat suppression in the visualization of wall hematoma in spontaneous dissection of the internal carotid artery].
Fiebach J, Brandt T, Knauth M, Jansen O. [mri with fat suppression in the visualization of wall hematoma in spontaneous dissection of the internal carotid artery].
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Verbal Fluency in Patients with Multiple Sclerosis – Functional MRI Study.
Verbal Fluency in Patients with Multiple Sclerosis – Functional MRI Study.
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A 29 year-old patient received conservative kinesitherapy and acupuncture after MRI diagnosis of discal herniation at L4-L5 level.
A 29 year-old patient received conservative kinesitherapy and acupuncture after MRI diagnosis of discal herniation at L4-L5 level. The treatment included: post-isometric relaxation of m. errector spinae, m.qudratus lumborum and m.iliopsoas, segmental massage, treatment with exercise, exercise to strengthen weak muscles, relaxation, extension therapy, active exercises from different starting positions and acupuncture. The greatest advantage was given to kinesitherapy in order to prevent the progression of the pathological process and improve the patient's functional condition. Аcupuncture was used to reduce pain caused by the herniated disc.
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The control MRI showed a complete change of the herniated disc.
Positive results was achieved after an intensive, three-month treatment. The control MRI showed a complete change of the herniated disc.
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He was investigated in the first 7 days after the onset of the symptoms using multimodal ultrasound (color duplex, B-Flow and 3D/4D imaging), CT and MRI studies.
A 66-year-old man with a history for ischemic stroke in the left middle cerebral artery (MCA) territory in the past received a sudden visual loss of the left eye. He was investigated in the first 7 days after the onset of the symptoms using multimodal ultrasound (color duplex, B-Flow and 3D/4D imaging), CT and MRI studies. The evolution of the clinical symptoms and the ophthalmic status are followup.
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The brain MRI detected an old ischemia in the left MCA territory.
In the accident onset the patient had full blindness of his left eye. The emergency head CT established normal imaging of the brain parenchyma, orbits and retrobulbar space. The brain MRI detected an old ischemia in the left MCA territory. Two-three hours after the onset the patient was able to recognize some light and hand movements. Funduscopy showed pale left optic papilla, “cherry red” spot symptom of the macula, ischemic signs of the retina (up and down) and attenuated arterioles. Multimodal ultrasound discovered severe (80%) stenosis of the left ICA, moderate (60%) stenosis of the right ICA, positive Doppler ophthalmic test on the left side and typical sings of CRAO – a small round hyperechoic artefact within the left optic nerve 14 mm behind the optic disc, increased vascular resistance of the left ophthalmic artery (OA) and increased venous flow within the CRAO territory. In the next days the venous flow decreased, a collateral arterial flow through the OA appeared. These changes correlated with a mild subjective vision improvement.
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VERBAL FLUENCY IN PATIENTS WITH MULTIPLE SCLEROSIS – FUNKTIONAL MRI STUDY
VERBAL FLUENCY IN PATIENTS WITH MULTIPLE SCLEROSIS – FUNKTIONAL MRI STUDY
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MRI-angiography confirmed hemispheric stroke and carotid siphon obstruction.
Twelve hours later the small apical thrombus resolved asymptomatically. Surgery at high perioperative risk was offered, but patient refused. 50h post UFH initiation patient became unresponsive, with right sided hemiparesis and NIHSS – 25. The LV thrombus was not seen anymore. Color coded duplex ultrasound showed that both carotids were free of thrombi, but the left one was with diminished flow. MRI-angiography confirmed hemispheric stroke and carotid siphon obstruction. Mechanical thrombectomy was not attempted due to absence of viability on penumbra imaging. Patient expired.
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In these patients the examination of the cervical vessels and upper limbs vessels with color coded duplex sonography (CCDS) was the first stage in diagnosing two different malignancies with CT of the chest and MRI phlebography.
Two young men without any specific complaint, concomitant diseases or family history. In these patients the examination of the cervical vessels and upper limbs vessels with color coded duplex sonography (CCDS) was the first stage in diagnosing two different malignancies with CT of the chest and MRI phlebography.
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Both men were directed for additional imaging and the results from CT and MRI phlebography correlated with ultrasound findings.
nal compression of left brachiocephalic vein, as well as vena cava superior syndrom. Both men were directed for additional imaging and the results from CT and MRI phlebography correlated with ultrasound findings. Two different tumor formations, the first one in supraclavicular area and the second one in the anterior and superior mediastinum, affect to varying degrees the cervical and upper limbs veins and vena cava superior.
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27. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 15, 2019, No. 1 , , ,

He was investigated in the first 7 days after the onset of the symptoms using multimodal ultrasound (color duplex, B-Flow and 3D/4D imaging), computed tomography (CT), and magnetic resonance imaging (MRI).
A 66-year-old man with a history for ischemic stroke in the left middle cerebral artery (MCA) territory in the past and sudden visual loss of the left eye was examined. He was investigated in the first 7 days after the onset of the symptoms using multimodal ultrasound (color duplex, B-Flow and 3D/4D imaging), computed tomography (CT), and magnetic resonance imaging (MRI). The evolution of the clinical symptoms, the ophthalmic status, and the change in sonographic findings before and after carotid endarterectomy were followed up.
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The brain MRI detected an old ischemia in the left MCA territory.
At the accident onset the patient had full blindness of his left eye. The head CT established normal imaging of brain parenchyma, orbits and retrobulbar space. The brain MRI detected an old ischemia in the left MCA territory. Two-three hours after the onset the patient was able to recognize some light and hand movements. Fundoscopy showed pale left optic papilla, “cherry red” spot symptom of the macula, ischemic signs of the retina and attenuated arterioles. Multimodal ultrasound discovered severe (80%) stenosis of the left ICA, moderate (60%) stenosis of the right ICA, positive Doppler ophthalmic test on the left side and typical sings of CRAO – a small round hyperechoic artefact within the left optic nerve 14 mm behind the optic disc, increased vascular resistance of the left ophthalmic artery (OA) and increased venous flow within the CRAO territory. Collateral blood flow through ciliary artery branches and normalization of ophthalmic venous blood flow were recorded in the following days. These changes correlated with a mild subjective vision improvement.
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With MRI, an old ischemic lesion of the left MCA territory is visualized.
With MRI, an old ischemic lesion of the left MCA territory is visualized.
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The results of the imaging ultrasound were compared with head CT and MRI data.
(color duplex scanning, B-Flow and 2D/3D/4D imaging) of extracranial brain arteries, optic nerves and papillae was performed. The optic nerve diameters were measured and the optic nerve/sheath index was determined. The blood flow in the central retinal artery was shown using B-flow and its velocities were recorded (Fig. 2) [1, 16, 17, 18]. The results of the imaging ultrasound were compared with head CT and MRI data.
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MRI center, M-TEH MDL, Pirogov,
MRI center, M-TEH MDL, Pirogov,
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Vascular sonography, CT angiography (CTA) and magnetic resonance imaging (MRI) are non-invasive methods and allow assessment of both the lumen of the vessel and its blood flow, and the vascular wall, becoming the first choice methods in patients with suspected TA [2, 10].
procedure. This determines the important role of imaging methods for timely diagnosis of TA. Conventional angiography was considered for a long time the gold standard in diagnosing this disease, but it is an invasive method and gives limited information about the changes in the vascular wall. Vascular sonography, CT angiography (CTA) and magnetic resonance imaging (MRI) are non-invasive methods and allow assessment of both the lumen of the vessel and its blood flow, and the vascular wall, becoming the first choice methods in patients with suspected TA [2, 10].
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The high sensitivity and specificity of the MRI in Takayasu disease has been confirmed by several studies [5, 11, 14].
The high sensitivity and specificity of the MRI in Takayasu disease has been confirmed by several studies [5, 11, 14]. Depending on the techniques used, the sensitivity, specificity and accuracy of the method ranges from 91%, 81% and 86% respectively in the non-contrast angiography and up to 100% for contrast-enhanced angiography. The assessment accuracy of the grade of stenotic lesions reaches 98% when the latter technique is used. The application of contrast allows seeing enhancement in the vascular wall, which is a sign of active inflammation [1]. Highresolution morphological images give information about the thickness of the vascular wall and the type of changes: edema, hemorrhages, thrombi, and calcifications. The individual layers of the wall are clearly distinguishable; it is also possible to localize the different types of changes.
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Most often these tumors are accidentally found, when imaging studies, such as magnetic resonance imaging (MRI), computed tomography (CT), and transthoracic/transesophageal echocardiography are conducted.
Myxoma is the most common primary benign tumor of the heart originating from the endocardium and is а rare cause of stroke, which has to be considered in younger patients or unclear etiology [5]. Most often these tumors are accidentally found, when imaging studies, such as magnetic resonance imaging (MRI), computed tomography (CT), and transthoracic/transesophageal echocardiography are conducted. Neurological complications are observed in 20-35% of patients with myxoma due to embolism in systemic circulation [6]. Ischemic stroke may be the first manifestation of the tumor, alone or in combination with mitral regurgitation and subsequent secondary pulmonary hypertension and heart failure due to the local tumor growth [7]. The only definitive treatment is the surgical excision of the tumor, leading to removal of the embolus source [8].
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